This is neglected, alcoholic with complaints of ataxia with MRI features consistent with wernicke's and cerebellar atrophy. Wernicke's encephalopathy is characterized by a quite distinct pattern of MR alterations, which include symmetrical alterations in the thalami, mamillary bodies, tectal plate, and periaqueductal area. Wernicke's encephalopathy is characterized by a quite distinct pattern of MR alterations, which include symmetrical alterations in the thalami, mamillary bodies, tectal plate, and periaqueductal area. In WE, the blood–brain barrier is defective in the periventricular regions, in which there is a high rate of thiamine-related glucose and oxidative metabolism . Contributed by Dr Swati Shah & Dr Sumer Sethi, MD
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