Wernicke encephalopathy: a complication of parenteral nutrition diagnosed by magnetic resonance imaging.

THIAMIN (vitamin B1) is a water-soluble vitamin involved in glucose metabolism. Its deficiency affects the cardiovascular (wet beriberi) and nervous (dry beriberi) systems, and in industrialized countries, it is commonly linked to chronic alcoholism. Wernicke encephalopathy (WE), a metabolic encephalopathy due to thiamine depletion, is clinically characterized by at least two among four features: nutritional deficit, oculomotor abnormalities, ataxia, and stupor. Laboratory tests (measurement of serum thiamine or erythrocyte transketolase activity) are diagnostic, but the radiologic confirmation can be achieved by magnetic resonance imaging (MRI) with abnormal hyperintense signal in the periaqueductal gray matter, the mamillary bodies, and around the third ventricle on fluid-attenuated inversion recovery and T2 MRI scans. We report a case of non alcoholic WE complicating postoperative total parenteral nutrition (TPN) lacking micronutrient supply and confirmed by MRI.