Kavitha B Chittaragi
JSS Medical College and Hospital, IndiaPresentation Title:
Wernicke’s encephalopathy beyond alcoholism: A radioclinical case series from a tertiary care center in South India
Abstract
Introduction: Wernicke’s Encephalopathy (WE) is a serious neurological condition caused by thiamine (vitamin B1) deficiency. While commonly associated with chronic alcoholism, a significant proportion of cases also occur in nonalcoholic individuals. The clinical presentation can be variable, making diagnosis particularly challenging in nonalcoholic patients. This case series aims to highlight the diverse etiologies, clinical manifestations and imaging features of WE to enhance awareness and support timely diagnosis and management.
Materials and Methods: This retrospective case series analyzed 14 patients diagnosed with WE between January 2020 and January 2025 at a tertiary care center in South India. Inclusion criteria were clinical suspicion of WE with supportive MRI findings showing bilateral symmetrical T2/FLAIR hyperintensities in typical regions (thalami, mammillary bodies, and periaqueductal gray). Patients with alternative diagnoses were excluded. Clinical details, comorbidities, etiological factors, imaging findings, treatment response, and outcomes were reviewed. All patients received thiamine therapy. Descriptive statistics were used to summarize the data.
Results: Among the 14 patients, 4 were chronic alcoholics, while 10 had nonalcoholic causes such as hyperemesis gravidarum (3), nutritional deficiency (4), parenteral nutrition (2), and CKD on dialysis (1). Most patients presented with altered sensorium and incomplete classical triad symptoms. MRI consistently showed typical WE findings, with additional atypical sites in some nonalcoholic cases. Thirteen patients improved with thiamine supplementation, while one died of intracerebral hemorrhage and another of sepsis. One patient was lost to follow-up. All pregnant patients had favorable obstetric outcomes.
Conclusions: Wernicke’s encephalopathy is often underdiagnosed, especially in nonalcoholic patients due to atypical presentations. Clinicians and radiologists should maintain a high index of suspicion for WE in patients with risk factors beyond alcohol use. Early diagnosis and treatment are critical to prevent irreversible neurological damage.
Biography
Kavitha B Chttaragi completed her DNB Radiology in the year 2017 from the National Board of Examinations, New Delhi. She is currently working in the Department of Radiodiagnosis, JSS Medical College and Hospital, Mysuru. She has over 8 publications in reputed journals. She is working on several research projects on Transcranial Doppler and artificial intelligence.
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