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BioMed Research International
Volume 2014 (2014), Article ID 503596, 12 pages
Review Article

MR Imaging Findings in Alcoholic and Nonalcoholic Acute Wernicke’s Encephalopathy: A Review

1Department of Biomorphological and Functional Sciences, University of Naples “Federico II,” Via Sergio Pansini 5, 80131 Naples, Italy
2Department of Neuroradiology, Umberto I Hospital, Viale San Francesco 2, Nocera Inferiore, 84014 Salerno, Italy

Received 15 January 2014; Accepted 28 May 2014; Published 24 June 2014

Academic Editor: Jessica Mandrioli

Copyright © 2014 Gaetana Manzo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Wernicke’s encephalopathy (WE) is a severe neurological syndrome caused by thiamine (vitamin B1) deficiency and clinically characterized by the sudden onset of mental status changes, ocular abnormalities, and ataxia. Apart from chronic alcoholism, the most common cause of WE, a lot of other conditions causing malnutrition and decreasing thiamine absorption such as gastrointestinal surgical procedures and hyperemesis gravidarum must be considered as predisposing factors. Due to its low prevalence and clinical heterogeneity, WE is often misdiagnosed, leading to persistent dysfunctions and, in some cases, to death. Nowadays, MR imaging of the brain, showing T2 and FLAIR hyperintensities in typical (thalami, mammillary bodies, tectal plate, and periaqueductal area) and atypical areas (cerebellum, cranial nerve nuclei, and cerebral cortex), is surely the most important and effective tool in the diagnostic assessment of WE. The aim of this paper is to propose a state of the art of the role of MR imaging in the early diagnosis of this complex disease.