<prompt> A lady in her first trimester with hyperemesis gravidarum wakes up with diplopia and mental confusion and nystagmus. What is the probable diagnosis?Pregnancy induced hypeensionWernickes syndromeOccipital infarctionPituitary apoplexy  <response>: Wernickes encephalopathy WE is a potentially reversible yet serious neurological manifestation caused by vitamin B1thiamine deficiency. It is commonly associated with heavy alcohol consumption. Other clinical associations are with hyperemesis gravidarum HG, starvation, and prolonged intravenous feeding. Most patients present with the triad of ocular signs, ataxia, and confusion, nystagmus It can be associated with life-threatening complication like central pontine myelinolysis CPM. 