Do acute lesions of Wernicke's encephalopathy show contrast enhancement? Report of three cases and review of the literature

Contrast medium was given intravenously to three nonalcoholic patients who undenwent MRI or CT in the acute stage of Wernicke's encephalopathy. Lesion s enhancement was not seen in one patient examined within ii days of clinic al onset, was mild in a another 3 days after clinical deterioration and mar ked in a patient examined 12 days after admission. Contrast enhancement of lesions was present in half of 12 cases of acute disease reported previousl y. There was a substantial overlap in the time interval between clinical on set and contrast-enhanced CT or MRI in the groups of enhancing and nonenhan cing lesions. Since contrast enhancement may be absent in acute WE, proton- density and T2-weighted images are more useful for diagnosis of this revers ible but potentially fatal condition.