History of alcohol abuse presents with altered conscious state including confusion and an ataxic gait.
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Selected FLAIR MRI images of the brain demonstrates hyperintensities in the periaqueductal region and the medial thalami. Note that this is on the background of global cerebral atrophy with CSF space notes to be more prominent than would normally be expected for a 46 year old.
Features are consistent with Wernicke-Korsakoff syndrome