Unless otherwise demonstrated, seizures during pregnancy that happen after 20 weeks of gestation are typically caused by eclampsia. In our clinical case we report the diagnostic challenge of Wernicke's encephalopathy occurring at 34 weeks and mimicking an eclamptic attack. This is about a 30-year-old female patient who suffers from hyperemesis gravidarum during her pregnancy. she has no known history of epilepsy .The patient was brought to the emergency room by medical transport at 34 weeks of gestation due to a seizure at home. The initial diagnosis was eclampsia. Emergency high-level extraction under general anesthesia was decided for maternal rescue. However, after extubation, the patient's condition deteriorated, with the onset of a confusion syndrome characterized by agitation, temporal-spatial disorientation, attention and vigilance disorders, and challenging communication. Angio MRI was performed, revealing signs consistent with Wernicke's encephalitis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10917636PMC
http://dx.doi.org/10.1016/j.radcr.2024.02.031DOI Listing

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