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KMID : 1201420130060010043
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Journal of Neurocritical Care
2013 Volume.6 No. 1 p.43 ~ p.46
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A Case of Atypical Wernicke’s Encephalopathy Showing Symmetric Cortical Lesions on MRI
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Roh Sook-Young
Yu Hyun-Jeung
Lee Ku-Eun
Kang Hyun-Seok
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Abstract
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Background: Magnetic resonance imaging (MRI) is currently considered the gold standard in confirming the diagnosis of Wernicke encephalopathy (WE), with classic findings including symmetric involvement of medial thalami, mammillary bodies and periaqueductal gray matter.
Case Report: A 58-year-old alcoholic male presented to our hospital with an altered state of consciousness, unsteady gait and dysmetria. Brain MRI revealed symmetric hyperintense lesions in the bilateral frontal cortex on fluid attenuated inversion recovery. A follow up MRI of the brain obtained 13 days after thiamine supplementation showed regression of these signal hyperintensities that involved cerebral cortex. Clinically, the patient’s symptoms recovered rapidly.
Conclusion: The spectrum of MRI changes was broader than those of classic WE. We believe that clinicians should remain aware that WE may present with both typical and atypical findings on MRI.
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KEYWORD
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Wernicke encephalopathy, Atypical MRI finding, Cerebral cortex
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