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[Value of MRI findings in Gayet-Wernicke encephalopathy]
1Service de Radiologie 2, CHU de Hautepierre, avenue Molière, 67098 Strasbourg Cedex, France.
Abstract:
Wernicke encephalopathy (Wernicke-Korsakoff encephalopathy) is related to thiamine deficiency. We report the MRI findings in four patients with visualization of bilateral and symmetrical hyperintense foci on T2W and FLAIR images involving the periaqueductal gray matter, the mamillary bodies and around the third ventricle. Diffusion weighted images obtained in two patients demonstrated mild hypersignal in the same areas. Contrast enhancement within the mamillary bodies was noted in one patient. Follow-up MRI obtained in three patients showed rapid regression of signal abnormalities without correlation with good clinical outcome.
Insights
Wernicke encephalopathy, a condition linked to thiamine deficiency, shows specific MRI patterns. These include symmetrical brain lesions that may resolve quickly on follow-up scans.
Area of Science:
- Neurology
- Radiology
- Nutritional Neuroscience
Background:
- Wernicke encephalopathy (WE), a neurological emergency, results from severe thiamine deficiency.
- It is often associated with chronic alcoholism, malnutrition, and certain medical conditions.
- Early diagnosis and treatment are crucial to prevent irreversible neurological damage.
Observation:
- This study details MRI findings in four patients diagnosed with Wernicke encephalopathy.
- Key observations include bilateral and symmetrical hyperintense foci on T2W and FLAIR imaging.
- Affected brain regions consistently involved the periaqueductal gray matter, mamillary bodies, and around the third ventricle.
Findings:
- Diffusion-weighted imaging (DWI) in two patients revealed mild hypersignal in the same characteristic areas.
- Contrast-enhanced MRI in one patient showed enhancement within the mamillary bodies.
- Follow-up MRI in three patients demonstrated rapid regression of these signal abnormalities.
Implications:
- The characteristic MRI findings can aid in the early diagnosis of Wernicke encephalopathy.
- Rapid regression of MRI signal abnormalities does not necessarily correlate with clinical recovery.
- These imaging patterns highlight the importance of prompt thiamine supplementation in suspected cases.