Marchiafava-Bignami Disease: A Rare Case Report and a Review of Literature

Abstract

Marchiafava-Bignami Disease (MBD) is an unusual neurological illness caused by prolonged alcoholism that is distinguished by demyelination of the corpus callosum. Clinicians encounter a wide range of alcohol-related diseases in their practice, and MBD is a rare condition that requires a high clinical suspicion due to its potential to mimic withdrawal symptoms, Wernicke’s-Korsakoff’s Psychosis, and various other neurological conditions, leading to confusion in diagnosis. It is a toxic-demyelinating syndrome that typically affects chronic alcoholics, but it has been described in rare instances in chronically malnourished teetotalers. The symptoms and warning signs are diffuse, and the onset could be abrupt or gradual. This is a case of a 54-year-old chronic alcoholic who presented with neurological symptoms. Magnetic Resonance Imaging (MRI) of the brain revealed typical features of MBD. The patient was treated with high doses of thiamine along with folic acid and other symptomatic treatments, after which significant improvement was observed. This case report reviews past reported cases to shed light on the varied presentation features of the disease. It adds to the limited corpus of MBD literature and highlights the intricate diagnostic process and management complexities associated with this condition. By integrating clinical observations, neuroimaging findings, and treatment outcomes, this report underscores the importance of maintaining a high clinical suspicion in cases involving alcohol abuse and the significance of tailored therapeutic strategies. As MBD continues to present diagnostic challenges, this report contributes valuable insights into its presentation, progression, and potential pathways to recovery. Therefore, it requires a high clinical suspicion for both clinical and radiological diagnosis.

Keywords

• alcohol
• corpus callosum
• magnetic resonance imaging
• thiamine