Wernicke-Korsakoff’s Encephalopathy (Thiamine Deficiency)

Case Courtesy of​

Prof Dr / Ramy Edward Asaad

Associate professor of Radiology- Cairo University

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04_Wernicke-encephalopathy (1 T2)
04_Wernicke-encephalopathy (2 FLAIR)
04_Wernicke-encephalopathy (3 DWI)
04_Wernicke-encephalopathy (4 ADC)
04_Wernicke-encephalopathy (5 MRV)
04_Wernicke-encephalopathy (6 MRV)
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Neuro-radiology
Wernicke-Korsakoff’s encephalopathy (Thiamine deficiency)
  • Pregnant lady having hyperemesis gravidarum with disturbed conscious level.
  • Symmetrical faint hyperintense T2/FLAIR and restricted DW signal at medial thalami, third ventricle, superior cerebellar vermis.
  • Normal MRV.
  • Always remember: Symmetry either global hypoxia/ischemia or toxic ( internal toxin= metabolic/ enzymatic deficiency or external toxin= toxic agent)
  • Symmetrical thalamic signal abnormality differential diagnosis:
  1. Wernicke’s encephalopathy
  2. Toxic encephalopathies
  3. Metabolic encephalopathies.
  4. Top of basilar artery ischaemia
  5. Deep cerebral venous sinus thrombosis.
  6. CNS lymphoma
  7. Bickerstaff brain stem encephalitis

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