Wernicke encephalopathy

Case contributed by Dr Zach Drew

Presentation

Memory loss and confusion ? encephalitis. Background of chronic alcohol excess

Patient Data

Age: 55 years
Gender: Male
MRI

Bilateral mammillary body signal abnormality with contrast enhancement. 

Mildly increased FLAIR signal around the cerebral aqueduct. 

There is an incidental small colloid cyst within the foramen of Monro.

Case Discussion

Wernicke encephalopathy is related to thiamine deficiency and is associated with excessive alcohol intake. Classic imaging features include symmetrical increased T2/FLAIR signal involving the mammillary bodies, and can also involve the dorsomedial thalami, tectal plate, periaqueductal area, and around the third ventricle. The usual clinical presentation is with the triad of confusion, ataxia, and ophthalmoplegia.

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