Thyrotoxicosis Associated Wernicke’s Encephalopathy

Spectrum of MR Imaging Findings in Wernicke Encephalopathy: Are Atypical Areas of Involvement Only Present in Nonalcoholic Patients?

“…Signal-intensity alterations of atypical locations, including the cerebral cortex (23%), ninth cranial nerve nuclei (23%), corpus callosum (5%), basal ganglia (5%), and cerebellum (14%), are similar to those in previous reports. 4,6,[8][9][10][11][12][13][14][15][16][17][18][19][20] Consciousness Status in Atypical WE MR Imaging Findings In this study, consciousness scores have a statistically positive correlation with the atypical sites involved and have significant association with the involvement of the cerebral cortex. These results could indicate that the more severe the consciousness change, the more atypical the MR imaging findings.…”

“…Three radiologists-1 neuroradiologist, 1 pediatric radiologist (including pediatric neuroradiology), and 1 musculoskeletal radiologist (10,8, and 8 years' experience, respectively)-retrospectively reviewed the brain MR images, blinded to the clinical symptoms or the etiology of WE, and a consensus was reached in conference. MR imaging results of WE were considered typical if symmetric hyperintense signal intensities were observed in the medial thalami, mammillary bodies, periaqueductal gray matter, periventricular region of the third and fourth ventricles, and the tectal plate on FLAIR images.…”

“…4,6,[9][10][11][12][13][14][15][16][17][18][19][20] Recently, some studies have been able to differentiate NA patients from AL patients according to differences in MR imaging findings. Zuccoli et al 8,21 suggested that AL and NA patients present different MR imaging patterns due to differences in the pathophysiologic processes.…”

MR Imaging Findings in 56 Patients with Wernicke Encephalopathy: Nonalcoholics May Differ from Alcoholics

“…3 Signal-intensity alterations in the cerebellum, cerebellar vermis, cranial nerve nuclei (CNN), red nuclei, dentate nuclei, caudate nuclei, splenium, and cerebral cortex represent atypical MR imaging findings. 3,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The prognosis of patients with WE depends on the time of onset of thiamine supplementation. When WE is unrecognized, Korsakoff psychosis and even death may ensue; therefore, neuroimaging plays a central role in the early stage of the disease.…”

Wernicke’s encephalopathy- a case report

“…The classic triad of confusion, ataxia and oculomotor abnormalities may be present in one third of the cases only. 2 In those cases where typical signs and symptoms are not present, lately, MRI findings are reported to be useful in the diagnosis. 3 Given some variations in presentation and persistent of memory symptoms, it is hoped that this case will help in early identification and treatment of such cases.…”