Gayet Wernicke's encephalopathy is a severe neurological disorder caused by vitamin B1 deficiency and remains a difficult diagnosis due to the variable clinical presentation, especially when the patient has no history of alcohol consumption. It is characterized by a clinical triad, often incomplete, that associates syndrome, ophthalmoplegia, and ataxia [1, 2]. Magnetic resonance imaging remains the gold standard for detection with a low sensitivity of 50% but a high specificity of 93% [2, 3]. However, patients with nonalcoholic Wernicke encephalopathy have highly variable neuroimaging results, making the diagnosis even more difficult. MRI shows a typical hypersignal on the T2, FLAIR and diffusion sequences, bilateral and symmetrical, on both sides of the third ventricle, of the medial part of the thalami, the periaqueductal, the mammary bodies, the tectal lamina, and the grey matter located in front of the fourth ventricle [3, 4]. These abnormalities reflect edema, necrosis, and the blood-brain barrier. The contrast enhancement in these same areas can be found after gadolinium injection. The prognosis is highly variable. It is favourable when the disease is diagnosed early and treatment is initiated promptly, there is complete remission of symptoms and the disappearance of signal abnormalities on MRI [3, 4].

Conflict of interest: The authors are contributed equally and declare no competing interest.

Contributions: All authors contributed equally in this work.

Funding statement: The authors received no specific funding for this work.

Acknowledgements: We would like to thank Prof. Jamal EL FENNI, chief of the Department of Radiology of Mohamed V Military Hospital, Rabat, Morocco, and Prof. Hassan EN-NOULI for their review of earlier drafts of the manuscript.

Ethical Approval: Not required. CONSENT Written consent has been obtained.

Guarantor: Dr. Daoud ALI MOHAMED. Radiology Department, Ibn Sina University Hospital, Rabat, Morocco.