BACKGROUND AND PURPOSE: Wernicke encephalopathy is a severe neurologic disorder 
that results from a dietary vitamin B1 deficiency. It is characterized by 
changes in consciousness, ocular abnormalities, and ataxia. This study was 
undertaken to analyze and compare findings on MR imaging and neurologic symptoms 
at clinical presentations of patients with Wernicke encephalopathy with and 
without a history of alcohol abuse.
MATERIALS AND METHODS: A multicenter study group retrospectively reviewed MR 
brain imaging findings, clinical histories, and presentations of 26 patients (14 
female, 12 male) diagnosed between 1999 and 2006 with Wernicke encephalopathy. 
The age range was 6-81 years (mean age, 46 .6+/-19 years).
RESULTS: Fifty percent of the patients had a history of alcohol abuse, and 50% 
had no history of alcohol abuse. Eighty percent showed changes in consciousness, 
77% had ocular symptoms, and 54% had ataxia. Only 38% of the patients showed the 
classic triad of the disease at clinical presentation. At MR examination, 85% of 
the patients showed symmetric lesions in the medial thalami and the 
periventricular region of the third ventricle, 65% in the periaqueductal area, 
58% in the mamillary bodies, 38% in the tectal plate, and 8% in the dorsal 
medulla. Contrast enhancement of the mamillary bodies was statistically 
positively correlated with the alcohol abuse group.
CONCLUSIONS: Our study confirms the usefulness of MR in reaching a prompt 
diagnosis of Wernicke encephalopathy to avoid irreversible damage to brain 
tissue. Contrast enhancement in the mamillary bodies is a typical finding of the 
disease in the alcoholic population.