Wernicke's encephalopathy with cortical abnormalities: clinicoradiological features: report of 3 new cases and review of the literature.

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.