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Wernicke encephalopathy

Case contributed by Ahmed Abdrabou
Diagnosis probable

Presentation

Deterioration of conscious level and agitation. Patient had gastric surgery 2 months ago for peptic ulcer.

Patient Data

Age: 45 years
Gender: Male

MRI Brain

mri

Abnormal signal bilateral and symmetrical involving the medial and posterior aspect of both thalami displaying bright signal in DWI, T2 and FLAIR.

Case Discussion

Previous gastric or bariatric surgeries are predisposing factors to various deficiency syndromes. Thiamine deficiency causes acute encephalopathy, usually affecting the medial thalamus, tectal plate and periaqueductal grey matter.

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