Wernicke’s encephalopathy is an acute neuropsychiatric syndrome caused by vitamin B1 deficiency, mainly manifesting as extraocular muscle paralysis, ataxia, and consciousness-psychosis. Foreign studies have shown that the most common cause of Wernicke’s encephalopathy is chronic alcoholism, but in recent years it has been found that non-alcoholic causes are also increasing, including: malnutrition, gastrointestinal surgery, recurrent vomiting and diarrhea, tumor and drug effects, systemic diseases such as long-term chronic infections. In addition to this, genetic factors are also a factor in causing the disease. The typical MRI features of the lesion are symmetrical long T1 and long T2 abnormalities in the midbrain aqueduct, around the fourth ventricle and medial thalamus, with less involvement of the cortex and corpus callosum. In addition to the typical MRI presentation, nonalcoholic Wernicke’s encephalopathy may also involve the red nucleus, cerebellar dentate nucleus, shell nucleus, caudate nucleus head, and cranial nerve nuclei. Vitamin B1 deficiency can cause impaired metabolism of sugar, lipids, and amino acids, resulting in reduced ATP synthesis in the brain, toxic damage, oxidative stress, and inflammatory responses, which in turn can cause neuromyelin damage and neuronal apoptosis. This may be the pathogenesis of causing Wernicke’s encephalopathy. With early diagnosis and timely treatment with vitamin B1, the disease can gradually improve or even be cured. Since most alcoholic encephalopathies are of chronic course, the damage to the nervous system is more permanent, so some foreign studies have reported the application of high doses of vitamin B1 for the treatment of this disease. Due to the complex etiology of the disease, the clinical manifestations are highly susceptible to misdiagnosis and mistreatment. Therefore, the presence of a history of alcohol consumption and nutritional disorders, along with the typical “triad of symptoms” or other non-specific symptoms such as headache and dizziness, may suggest Wernicke’s encephalopathy.