title: Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients.
abstract: OBJECTIVE
  Wernicke encephalopathy is a severe neurologic disorder that results from a dietary vitamin B1 deficiency. It is characterized by changes in consciousness, ocular abnormalities, and ataxia. This study was undertaken to analyze and compare findings on MR imaging and neurologic symptoms at clinical presentations of patients with Wernicke encephalopathy with and without a history of alcohol abuse.
  
  
  METHODS
  A multicenter study group retrospectively reviewed MR brain imaging findings, clinical histories, and presentations of 26 patients (14 female, 12 male) diagnosed between 1999 and 2006 with Wernicke encephalopathy. The age range was 6-81 years (mean age, 46 .6+/-19 years).
  
  
  RESULTS
  Fifty percent of the patients had a history of alcohol abuse, and 50% had no history of alcohol abuse. Eighty percent showed changes in consciousness, 77% had ocular symptoms, and 54% had ataxia. Only 38% of the patients showed the classic triad of the disease at clinical presentation. At MR examination, 85% of the patients showed symmetric lesions in the medial thalami and the periventricular region of the third ventricle, 65% in the periaqueductal area, 58% in the mamillary bodies, 38% in the tectal plate, and 8% in the dorsal medulla. Contrast enhancement of the mamillary bodies was statistically positively correlated with the alcohol abuse group.
  
  
  CONCLUSIONS
  Our study confirms the usefulness of MR in reaching a prompt diagnosis of Wernicke encephalopathy to avoid irreversible damage to brain tissue. Contrast enhancement in the mamillary bodies is a typical finding of the disease in the alcoholic population.
authors: Department of Radiology, Intensive Care Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy, and Magnetic Resonance Unit, University Hospital of Badalona, Barcelona, Spain. giulio.zuccoli@asmn.re.it
authors: G
authors: G
authors: Zuccoli
authors: M
authors: M
authors: Gallucci
authors: J
authors: J
authors: Capellades
authors: L
authors: L
authors: Regnicolo
authors: B
authors: B
authors: Tumiati
authors: T Cabada
authors: TC
authors: Giadás
authors: W
authors: W
authors: Bottari
authors: J
authors: J
authors: Mandrioli
authors: M
authors: M
authors: Bertolini
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007558:Italy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014899:Wernicke Encephalopathy / Q000473:pathology*
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