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Gadolinium-enhanced MR findings in a pediatric case of Wernicke encephalopathy
1Department of Radiology, Baptist Medical Center, Little Rock, Ark, USA.
Abstract:
This report describes the postcontrast MR findings of Wernicke encephalopathy seen in a malnourished 11-year-old boy. The examination showed increased signal on T2-weighted images in the periaqueductal gray matter and medial thalami. On T1-weighted acquisition, these areas showed decreased signal intensity, but on postcontrast T1-weighted examination, they showed moderately intense enhancement. Also noted on the postcontrast examination was mamillary body enhancement.
Insights
Wernicke encephalopathy (WE) in a malnourished boy showed characteristic MRI findings. Postcontrast imaging revealed enhancement in the periaqueductal gray matter, medial thalami, and mamillary bodies, aiding diagnosis.
Area of Science:
- Neurology
- Radiology
- Pediatric Medicine
Background:
- Wernicke encephalopathy (WE) is a neurological emergency often associated with thiamine deficiency.
- Malnutrition is a significant risk factor for developing WE.
- Early diagnosis and treatment are crucial to prevent severe neurological sequelae.
Observation:
- This case report details the magnetic resonance imaging (MRI) findings in an 11-year-old malnourished boy diagnosed with WE.
- The patient presented with symptoms indicative of neurological compromise.
Findings:
- T2-weighted MRI sequences demonstrated increased signal intensity in the periaqueductal gray matter and medial thalami.
- T1-weighted sequences showed decreased signal intensity in these same regions.
- Postcontrast T1-weighted imaging revealed moderately intense enhancement in the periaqueductal gray matter and medial thalami, along with enhancement of the mamillary bodies.
Implications:
- Postcontrast MRI is a valuable tool for diagnosing Wernicke encephalopathy, particularly in pediatric cases.
- Characteristic imaging findings can facilitate prompt treatment initiation.
- This case highlights the importance of considering WE in malnourished children presenting with neurological symptoms.
