Short communication| Volume 334, ISSUE 1-2, P172-175, November 15, 2013

Isolated mammillary body involvement on MRI in Wernicke's encephalopathy

  • Shin C. Beh
    Corresponding author at: Department of Neurology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390, United States. Tel.: +1 214 645 0555; fax: +1 214 645 0556.
    Department of Neurology, University of Texas Southwestern Medical Center at Dallas, United States
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  • Teresa C. Frohman
    Department of Neurology, University of Texas Southwestern Medical Center at Dallas, United States
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  • Elliot M. Frohman
    Department of Neurology, University of Texas Southwestern Medical Center at Dallas, United States

    Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, United States
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Published:August 19, 2013DOI:


      A 48-year-old woman, with a remote history of gastric-banding as well as recent-onset post-prandial vomiting and excessive wine-drinking, was admitted with progressively-worsening gait incoordination. She showed gaze-evoked nystagmus and gait ataxia. Brain MRI revealed conspicuous, isolated, symmetrical T2/FLAIR-hyperintensities and gadolinium-enhancement of the mammillary bodies. Serum thiamine and folate were low. Following thiamine and folate replacement therapy, her ataxia resolved. Given the rising number of bariatric procedures, we discuss the importance of recognizing thiamine-deficiency in these patients. Additionally, while isolated involvement of the mammillary bodies is a rare finding in this disorder, we highlight radiologic changes that neurologists should recognize.


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