Dry Beriberi During Pregnancy After Hyperemesis Gravidarum: A Case Report of Axonal Sensorimotor Polyneuropathy

Thiamine (vitamin B1) deficiency is a preventable complication of prolonged hyperemesis gravidarum, and the resulting malnutrition may lead to disabling peripheral neuropathy. We report the case of a 25-year-old primigravida who presented at 20 weeks of gestation with rapidly progressive distal weakness and glove-and-stocking paresthesias. Electroneuromyogram testing revealed an axonal sensorimotor polyneuropathy, and the serum thiamine level was low, supporting the diagnosis of thiamine deficiency-related neuropathy (dry beriberi). High-dose intravenous thiamine resulted in partial neurological improvement. A structured multidisciplinary inpatient rehabilitation program led to major functional gains, with the patient progressing from wheelchair dependence to independent ambulation within two months. This case highlights the importance of early recognition of thiamine deficiency in pregnancy and the added value of a structured multidisciplinary physical medicine and rehabilitation program, alongside prompt thiamine replacement, in restoring safe ambulation and functional independence during pregnancy.