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Updated: Aug 16, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
[MRI findings in Wernicke encephalopathy]
A Bitsch1, M Seipelt, H H Rustenbeck
1Abteilung Neurologie, Georg-August-Universität, Göttingen.
Abstract:
Wernicke's encephalopathy (WE) is a consequence of vitamin B1 (thiamine) deficiency and in the majority of cases due to alcoholism. We report here the case of a 26-year-old male alcoholic who had stayed helplessly at home for 4 days until hospital admission. Clinical diagnosis was difficult due to major disturbance of consciousness. MRI showed an increase in signal intensity (T2-, FLAIR-weighted) around the third ventricle, the quadrigeminal bodies, the fornices, the mamillary bodies, the floor of the fourth ventricle and around the aqueduct. These findings were indicative of WE although of unusual extent. In this case MRI correlated well with clinical symptomatology. Therapy with thiamine was started immediately and symptoms as well as MRI findings resolved partially. The presented case illustrates the diagnostic usefulness of MRI in WE especially if the patient is of reduced consciousness and clinical investigation is limited.
Insights
Wernicke
Area of Science:
- Neurology
- Radiology
- Nutritional Neuroscience
Background:
- Wernicke's encephalopathy (WE) results from vitamin B1 (thiamine) deficiency, often linked to alcoholism.
- Diagnosis can be challenging, particularly with significant disturbances in consciousness.
- Early recognition is crucial for effective treatment and preventing severe neurological deficits.
Observation:
- A 26-year-old male alcoholic presented with severe disturbance of consciousness.
- MRI revealed extensive signal abnormalities characteristic of WE in specific brain regions.
Findings:
- Magnetic Resonance Imaging (MRI) demonstrated T2/FLAIR hyperintensities in periventricular and tectal areas.
- These MRI findings correlated with the clinical presentation, aiding diagnosis.
Implications:
- This case highlights MRI's diagnostic value in Wernicke's encephalopathy, especially when clinical assessment is limited.
- Prompt thiamine therapy led to partial symptom and MRI finding resolution.
