International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties. Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. ABSTRACT Introduction:

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... Hyperemesis gravidarum during pregnancy can be complicated by Wernicke's encephalopathy (WE). It is a neuropsychiatric syndrome due to thiamine deficiency generated by increased requirement and loss. It is a fatal but preventable complication. The management and prevention of this disorder is still unclear for lack of guidelines. Case Series: These are two cases of Wernicke's encephalopathy complicating hyperemesis gravidarum occurred in two women during the first trimester of pregnancy. Diagnosis was confirmed by MRI scan, and the treatment consisted of intravenous thiamine and parenteral nutrition with a good maternal and fetal outcome. Conclusion: Wernicke's encephalopathy must be suspected in women showing its characteristic clinical signs to avoid worse outcome, such maternofetal death or permanent neuromuscular sequelae. Medical management by thiamine is simple and efficient. AbstrAct Introduction: Hyperemesis gravidarum during pregnancy can be complicated by Wernicke's encephalopathy (WE). It is a neuropsychiatric syndrome due to thiamine deficiency generated by increased requirement and loss. It is a fatal but preventable complication. the management and prevention of this disorder is still unclear for lack of guidelines. case series: these are two cases of Wernicke's encephalopathy complicating hyperemesis gravidarum occurred in two women during the first trimester of pregnancy. Diagnosis was confirmed by MrI scan, and the treatment consisted of intravenous thiamine and parenteral nutrition with a good maternal and fetal outcome. conclusion: Wernicke's encephalopathy must be suspected in women showing its characteristic clinical signs to avoid worse outcome, such maternofetal death or permanent neuromuscular sequelae. Medical management by thiamine is simple and efficient.