Reversible MRI abnormalities in an unusual paediatric presentation of Wernicke's encephalopathy.
BACKGROUND
We report an unusual paediatric presentation of acute Wernicke's encephalopathy in a 12-year-old boy affected by chronic gastrointestinal disease. MRI demonstrated, in addition to the typical diencephalic and mesencephalic signal abnormalities on T2-weighted images, enhancement of the mammillary bodies and the floor of the hypothalamus.


METHODS
Following parenteral administration of thiamine for 4 days, the patient recovered from his neurological deficits and on follow-up enhanced MRI 1 month later, no signal abnormalities were found nor was there diencephalic or mesencephalic atrophy, as is usual in the chronic phase of the disease.


RESULTS
MRI provides crucial information in the diagnosis of Wernicke's encephalopathy, either in the acute or chronic phases of the disease.


CONCLUSIONS
Our report provides an additional clue for recognition of the acute phase of the disease; enhancement of the floor of the hypothalamus has not previously been described despite its recorded involvement at autopsy.
Institute of Radiology "P. Cignolini", University of Palermo, Via del Vespro, 127, I-90 127 Palermo, Italy. sparacia@unipa.it
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G
Sparacia
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Banco
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R
Lagalla
D000208:Acute Disease; D002648:Child; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008326:Mammillary Bodies / Q000473:pathology*; D013831:Thiamine / Q000627:therapeutic use; D014899:Wernicke Encephalopathy / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
D003287:Contrast Media; D019786:Gadolinium DTPA; D013831:Thiamine