[Karl Wernicke (1848–1905), professor of neurology and psychiatry in Breslau and Halle, Germany]

• MEDICAL EMERGENCY!

Cause: vitamin B1 (thiamine) deficiency

Predisposed:

• malnutrition ← chronic alcoholism, GI neoplasm, hematologic neoplasm, chronic dialysis, bowel obstruction, hyperemesis gravidarum, prolonged parenteral Rx

• classic triad of
  • altered consciousness
  • ocular dysfunction (= ophthalmoplegia)
  • ataxia
• anterograde amnesia

Affected areas: medial thalami, periaqueductal gray matter, mamillary bodies, tectal plate

MR:

• symmetric T2 prolongation
• petechial hemorrhage
• diffusion restriction
• contrast enhancement

Rx: IV replacement of thiamine