Wernicke’s Encephalopathy with Cortical Abnormalities: Clinicoradiological Features: Report of 3 New Cases and Review of the Literature

Abstract

Objective: To investigate clinical and magnetic resonance imaging (MRI) features of Wernicke’s encephalopathy with cortical abnormalities (WEc). Methods: We retrospectively evaluated the clinical features and MRI findings in 3 cases of WEc in comparison with those of 7 previously reported cases. Results: Besides the classical triad of ocular abnormalities, ataxia and global confusion, muscular weakness of all extremities was frequently recognized (5 of 6 evaluable cases; 83%). During the clinical courses, 2 patients (20%) died and 1 fell into a vegetative state. The cortical abnormalities were distributed in the frontal and parietal lobes, especially around the bilateral central sulcus, in all cases. In 1 case, the cortical abnormality was irreversible, and the abnormal lesion, similar to that seen in laminar necrosis, persisted. Conclusions: Bilateral frontal cortical abnormalities around the central sulcus and muscular weakness of all extremities might be the characteristic features of WEc.