A Woman with Memory Loss, Anhedonia, and Temporal Wasting

She had been receiving immunomodulation for her breast cancer and reported drinking one glass of wine weekly. She also reported dysgeusia, xerostomia, and sleep disturbance. Initial contrasted MRI and electroencephalography were unrevealing, with no signs of brain metastases or seizures. Because her neuropsychiatric symptoms seemed out of proportion to a potential depressive disorder (“pseudodementia”), a nutritional deficiency was suspected. Repeat MRI with particular focus on the mamillary bodies was requested, which showed abnormal enhancement (Figure 1) and confirmed the diagnosis of Wernicke–Korsakoff syndrome.