Evaluation of Demographic, Clinical, and Radiologic Characteristics of Patients with Wernicke's Encephalopathy: A Retrospective Study

Abstract

Wernicke's encephalopathy (WE) is an acute neurologic condition caused by thiamine (vitamin B1) deficiency that can lead to permanent neurologic damage if not diagnosed and treated early. In this retrospective study, the demographic, clinical, etiologic, and radiologic characteristics and functional outcomes of 26 patients aged over 18 years who were diagnosed as having WE and whose diagnoses were supported through magnetic resonance imaging (MRI) findings at our center between January 2000 and September 2025 were examined. The mean age of the patients was 48.35 years, and the majority were female. The most common clinical findings were altered mental status, ataxia, and oculomotor disorders. Etiologically, the most frequent causes were systemic conditions such as chronic alcoholism, cancer, dialysis, and total parenteral nutrition, followed by malabsorption, malnutrition, persistent vomiting, and bariatric surgery. Imaging findings showed medial thalamus involvement as the most prominent feature, and hyperintensity was frequently observed in T2/FLAIR sequences. Patients followed for at least 1 month had an average follow-up period of 14.1 months, and functional status was assessed using the modified Rankin Scale, with an average score of 0.9 ± 1.29. In contrast, diffusion-weighted imaging (DWI) positivity was significantly higher, particularly in cases associated with cancer, dialysis, and total parenteral nutrition (p=0.016). WE is a condition that can arise from various etiologies, requiring careful clinical and radiologic evaluation. Early diagnosis and thiamine treatment are critically important in preventing neurologic sequelae, especially in high-risk patient groups.