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Wernicke Encephalopathy: MR Findings at Clinical Presentation in Twenty-Six Alcoholic and Nonalcoholic Patients

Wernicke Encephalopathy: MR Findings at Clinical Presentation in Twenty-Six Alcoholic and... This Article Figures Only Full Text Full Text (PDF) Supplemental Online Tables Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Zuccoli, G. Articles by Bertolini, M. Search for Related Content PubMed PubMed Citation Articles by Zuccoli, G. Articles by Bertolini, M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 28:1328-1331, August 2007 DOI 10.3174/ajnr.A0544 © 2007 American Society of Neuroradiology BRAIN Wernicke Encephalopathy: MR Findings at Clinical Presentation in Twenty-Six Alcoholic and Nonalcoholic Patients G. Zuccoli a , M. Gallucci f , J. Capellades e , L. Regnicolo g , B. Tumiati b , T. Cabada Giadás h , W. Bottari c , J. Mandrioli i and M. Bertolini d a Department of Radiology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy b Division of Internal Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy c Intensive Care Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy d Department of Physics, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy e Magnetic Resonance Unit, University Hospital of Badalona, Barcelona, Spain f Department of Radiology, University Hospital S. Salvatore, L’Aquila, Italy g Department of Radiology, Hospital Umberto I, Ancona, Italy h Department of Radiology, Hospital of Navarra, Spain i Department of Neurology, University of Modena and Reggio Emilia, Italy Address correspondence to Dr. Giulio Zuccoli, Radiology Department, Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42100, Reggio Emilia, Italy; e-mail: giulio.zuccoli@asmn.re.it 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. This article has been cited by other articles: L. C. Hygino da Cruz Jr, R. C. Domingues, I. Vilanova, and E. L. Gasparetto MR Imaging Findings in Wernicke Encephalopathy: Nonalcoholics May Be Similar to Alcoholics AJNR Am. J. Neuroradiol., June 1, 2010; 31(6): E54 - E54. Full Text PDF C. Santos Andrade, L. Tavares Lucato, M. da Graca Morais Martin, M. Joaquina Marques-Dias, L. Antonio Pezzi Portela, G. Scarabotolo Gattas, and C. da Costa Leite Non-alcoholic Wernicke's encephalopathy: broadening the clinicoradiological spectrum Br. J. Radiol., May 1, 2010; 83(989): 437 - 446. Abstract Full Text PDF A. B. Smith and J. G Smirniotopoulos Imaging evaluation of demyelinating processes of the central nervous system Postgrad. Med. J., April 1, 2010; 86(1014): 218 - 229. Abstract Full Text PDF E. V. Sullivan and A. Pfefferbaum Neuroimaging of the Wernicke-Korsakoff Syndrome Alcohol Alcohol., March 1, 2009; 44(2): 155 - 165. Abstract Full Text PDF E. Kim, J. Ku, K. Namkoong, W. Lee, K. S. Lee, J.-Y. Park, S. Y. Lee, J.-J. Kim, S. I. Kim, and Y.-C. Jung Mammillothalamic functional connectivity and memory function in Wernicke's encephalopathy Brain, February 1, 2009; 132(2): 369 - 376. Abstract Full Text PDF G. Zuccoli and N. Pipitone Neuroimaging Findings in Acute Wernicke's Encephalopathy: Review of the Literature Am. J. Roentgenol., February 1, 2009; 192(2): 501 - 508. Abstract Full Text PDF A. B. Smith, J. G. Smirniotopoulos, E. J. Rushing, and S. J. Goldstein Bilateral Thalamic Lesions Am. J. Roentgenol., February 1, 2009; 192(2): W53 - W62. Abstract Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Wernicke Encephalopathy: MR Findings at Clinical Presentation in Twenty-Six Alcoholic and Nonalcoholic Patients

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A0544
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) Supplemental Online Tables Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Zuccoli, G. Articles by Bertolini, M. Search for Related Content PubMed PubMed Citation Articles by Zuccoli, G. Articles by Bertolini, M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 28:1328-1331, August 2007 DOI 10.3174/ajnr.A0544 © 2007 American Society of Neuroradiology BRAIN Wernicke Encephalopathy: MR Findings at Clinical Presentation in Twenty-Six Alcoholic and Nonalcoholic Patients G. Zuccoli a , M. Gallucci f , J. Capellades e , L. Regnicolo g , B. Tumiati b , T. Cabada Giadás h , W. Bottari c , J. Mandrioli i and M. Bertolini d a Department of Radiology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy b Division of Internal Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy c Intensive Care Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy d Department of Physics, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy e Magnetic Resonance Unit, University Hospital of Badalona, Barcelona, Spain f Department of Radiology, University Hospital S. Salvatore, L’Aquila, Italy g Department of Radiology, Hospital Umberto I, Ancona, Italy h Department of Radiology, Hospital of Navarra, Spain i Department of Neurology, University of Modena and Reggio Emilia, Italy Address correspondence to Dr. Giulio Zuccoli, Radiology Department, Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42100, Reggio Emilia, Italy; e-mail: giulio.zuccoli@asmn.re.it 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. This article has been cited by other articles: L. C. Hygino da Cruz Jr, R. C. Domingues, I. Vilanova, and E. L. Gasparetto MR Imaging Findings in Wernicke Encephalopathy: Nonalcoholics May Be Similar to Alcoholics AJNR Am. J. Neuroradiol., June 1, 2010; 31(6): E54 - E54. Full Text PDF C. Santos Andrade, L. Tavares Lucato, M. da Graca Morais Martin, M. Joaquina Marques-Dias, L. Antonio Pezzi Portela, G. Scarabotolo Gattas, and C. da Costa Leite Non-alcoholic Wernicke's encephalopathy: broadening the clinicoradiological spectrum Br. J. Radiol., May 1, 2010; 83(989): 437 - 446. Abstract Full Text PDF A. B. Smith and J. G Smirniotopoulos Imaging evaluation of demyelinating processes of the central nervous system Postgrad. Med. J., April 1, 2010; 86(1014): 218 - 229. Abstract Full Text PDF E. V. Sullivan and A. Pfefferbaum Neuroimaging of the Wernicke-Korsakoff Syndrome Alcohol Alcohol., March 1, 2009; 44(2): 155 - 165. Abstract Full Text PDF E. Kim, J. Ku, K. Namkoong, W. Lee, K. S. Lee, J.-Y. Park, S. Y. Lee, J.-J. Kim, S. I. Kim, and Y.-C. Jung Mammillothalamic functional connectivity and memory function in Wernicke's encephalopathy Brain, February 1, 2009; 132(2): 369 - 376. Abstract Full Text PDF G. Zuccoli and N. Pipitone Neuroimaging Findings in Acute Wernicke's Encephalopathy: Review of the Literature Am. J. Roentgenol., February 1, 2009; 192(2): 501 - 508. Abstract Full Text PDF A. B. Smith, J. G. Smirniotopoulos, E. J. Rushing, and S. J. Goldstein Bilateral Thalamic Lesions Am. J. Roentgenol., February 1, 2009; 192(2): W53 - W62. Abstract Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Aug 1, 2007

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