ABSTRACT
Objective Objective The present study was to increase the awareness of nonalcoholic Wernicke's encephalopathy ( WE) to reduce its misdiagnosis.Methods The clinical features and MR imaging findings in 6 patients with nonalcoholic WE were retrospectively analyzed.Results All patients exhibited different degrees of unconsciousness.Only two patients presented with the typical triad of neuro-ophthalmologic manifestations, ataxia, and global confusion.All patients presented with typical MR features characterized by bilaterally altered signal of the medial thalamus, periventricular region of the third ventricle and periaqueductal area. In addition, two patients developed symmetric cortical and facial nerve nucleus involvements with deep coma, which was clinically rare.The average clinical recovery and MRI imaging recovery times were 7.5 months and 2.8 months, respectively,.Two patients with deep coma showed a poor prognosis:1 patient died, and the other had a sever spastic paralysis of her extremities and mental retardation during a follow -up of 2 years.Two patients with deep coma showed symmetric hyperintensities on diffusion -weighted imaging ( DWI) .Conclusions MRI images are useful in the early diagnosis of nonalcoholic WE.Cortical and cranial nerve nucleus involve-ment in nonalcoholic WE patients may be an indication of irreversible damage and a poor prognosis.In addition, hyperintensities on DWI may also indicate an unfavorable prognosis.
