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Wernicke encephalopathy

Case contributed by Lee-Anne Slater
Diagnosis probable

Presentation

Presented with confusion, ataxia and nystagmus on the background of a long history of alcohol abuse.

Patient Data

Age: 70 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

FLAIR hyperintensities in the periaqueductal region, dorsal brainstem, medial thalami surrounding the third ventricle on the background of chronic small vessel ischemia. The mamillary bodies are also noted to be atrophic in this patient. There is also FLAIR hyperintensity seen involving the genu and splenium of the corpus callosum. Restricted diffusion around the 3rd ventricle/medial thalamus.

Case Discussion

These features are in keeping with Wernicke encephalopathy with the FLAIR hyperintensity in the corpus callosum raising the possibility of Marchiafava-Bignami disease.

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