Cortical linear lesions in Wernicke's encephalopathy: can diffusion-weighted imaging herald prognostic information?

To the Editor: Typical clinical features of Wernicke’s encephalopathy are caused by vitamin B1 deficiency and include confusion, ataxia, and ophthalmoplegia. Although it can occur in all malnourished patients, it is far more frequent in alcoholics. Brain MRI is a central diagnostic tool that usually discloses high signal lesions in T2-weighted imaging symmetrically affecting mammillary bodies, the thalamus, hypothalamus, periaqueductal gray matter, midbrain, and the cerebellum. Cortical damage and diffusion-weighted imaging findings were both seldom reported in Wernicke’s encephalopathy.