A combined case of wernicke and metronidazole induced encephalopathy? Overlapping pathophysiologic pathways and MR imaging features

•Wernicke and metronidazole induced encephalopathies have significantly overlapping clinical and MR features.•Knowledge of atypical MR features may help differentiate WE and MIE.•Non-alcoholic WE should be considered in all nutritionally deficient patients with progressive encephalopathy•WE and MIE may co-exist, requiring increased vigilance for both conditions.