Wernicke encephalopathy with atypical findings on magnetic resonance imaging

MRI brain revealed nearly symmetrical bilateral T2 and fluid-attenuated inversion recovery (FLAIR) hyperintensities in entire pons and midbrain including cerebral peduncles, thalami including pulvinar and periventricular areas of third ventricle, anterior thalamo-capsulo-ganglionic regions, corona radiata, genu and proximal body of corpus callosum extending into the centrum semiovale on the left side, anterior to the fourth ventricle, and in the periaqueductal region [Figure 1], [Figure 2], [Figure 3]. Laboratory investigations, including blood glucose, serum creatine, electrolytes, and liver function tests, were within normal limits. Whole body 18 fluorodeoxyglucose positron-emission tomography-computed tomography (CT) scan showed no metabolically active lesions.