Reversible MRI abnormalities in an unusual paediatric presentation of Wernicke's encephalopathy

Pediatr Radiol. 1999 Aug;29(8):581-4. doi: 10.1007/s002470050652.

Abstract

Background: We report an unusual paediatric presentation of acute Wernicke's encephalopathy in a 12-year-old boy affected by chronic gastrointestinal disease. MRI demonstrated, in addition to the typical diencephalic and mesencephalic signal abnormalities on T2-weighted images, enhancement of the mammillary bodies and the floor of the hypothalamus.

Materials and methods: Following parenteral administration of thiamine for 4 days, the patient recovered from his neurological deficits and on follow-up enhanced MRI 1 month later, no signal abnormalities were found nor was there diencephalic or mesencephalic atrophy, as is usual in the chronic phase of the disease.

Results: MRI provides crucial information in the diagnosis of Wernicke's encephalopathy, either in the acute or chronic phases of the disease.

Conclusion: Our report provides an additional clue for recognition of the acute phase of the disease; enhancement of the floor of the hypothalamus has not previously been described despite its recorded involvement at autopsy.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Child
  • Contrast Media
  • Gadolinium DTPA
  • Humans
  • Hypothalamus / pathology*
  • Magnetic Resonance Imaging*
  • Male
  • Mammillary Bodies / pathology*
  • Thiamine / therapeutic use
  • Wernicke Encephalopathy / diagnosis*
  • Wernicke Encephalopathy / drug therapy
  • Wernicke Encephalopathy / pathology

Substances

  • Contrast Media
  • Gadolinium DTPA
  • Thiamine