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Wernicke's Encephalopathy - Case 2

A 52 year old man with a history of alcohol abuse was brought in by his family confused. On exam, he was bilateral sixth nerve palsies and difficulty with upgaze on cranial nerve testing.

Show the Involvement of the Periaqueductal Grey     Show the Involvement of the Medial Hypothalamus

MRI Axial Flair images. Note the abnormal signal in the periaqueductal gray matter (left and middle images) of the pons and midbrain, as well as the hypothalamus (right image). Wernicke's encephalopathy occurs from thiamine deficiency, most classically seen with alcoholics, but also seen in poor nutrition of other causes.

Revised 05/06/06.
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