Wernicke's encephalopathy is a metabolic disorder caused by deficiency of 
thiamine (vitamin B1) seen in alcoholics and even in nonalcoholic patients, 
classically presenting with a triad of ataxia, ophthalmoplegia, and altered 
mental status. Typical findings in magnetic resonance imaging are represented by 
symmetric signal alterations in medial thalami, mamillary bodies, tectal plate, 
and periaqueductal area and atypical findings involve lesions in cerebellum, 
midline vermis, red nuclei, dentate, caudate, cranial nerve nuclei, splenium and 
cerebral cortex. We report here a case of nonalcoholic starvation induced 
atypical WE showing symmetrical lesions in substantia nigra in addition to the 
classical neuroradiological findings.