A case of Wernicke’s encephalopathy is reported. A 53-year-old alcoholic man was presented with acute confusion, upward gaze palsy of the left eye and gait ataxia for 5 days. The typical findings upon MRI of the brain showed multiple, scattered, small non-enhanced low signal intensity on T1WI, high signal intensity on T2WI involving at bilateral basal ganglias, and thalami, midbrain, pons, and periventricular regions with evidence of atrophic changes of brain and the mamillary bodies. After treatment with intravenous thiamine 100 mg/day, the left upward gaze palsy was fully recovered at the 8th day of treatment. The mental status and gait ataxia gradually improved.

Keywords: Wernicke’s encephalopathy