Atormac
Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 2022  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 Search
 
  
 Resource Links
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (724 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this Article
   References
   Article Figures

 Article Access Statistics
    Viewed1340    
    Printed26    
    Emailed0    
    PDF Downloaded37    
    Comments [Add]    

Recommend this journal

 


 
Table of Contents    
LETTER TO EDITOR
Year : 2017  |  Volume : 65  |  Issue : 3  |  Page : 642-643

A rare case of Marchiafava–Bignami disease: Extracallosal lesions involving bilateral medipeduncle


Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China

Date of Web Publication9-May-2017

Correspondence Address:
Xiu Chen
Department of Neurology, The Affiliated Hospital of Southwest Medical University, Taiping Street 25, Luzhou, Sichuan - 646000
China
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/neuroindia.NI_365_16

Rights and Permissions



How to cite this article:
Xuehan L I, Zhiyu L V, Wang P, Chen X. A rare case of Marchiafava–Bignami disease: Extracallosal lesions involving bilateral medipeduncle. Neurol India 2017;65:642-3

How to cite this URL:
Xuehan L I, Zhiyu L V, Wang P, Chen X. A rare case of Marchiafava–Bignami disease: Extracallosal lesions involving bilateral medipeduncle. Neurol India [serial online] 2017 [cited 2019 Aug 23];65:642-3. Available from: http://www.neurologyindia.com/text.asp?2017/65/3/642/205928


Sir,

Marchifava–Bignami disease (MBD) is a rare condition that mostly affects middle-aged males, often causing necrosis or demyelination in the corpus callosum symmetrically. This disease was first described by two Italian pathologists, Ettore Machiafava and Amico Bignami.[1] It has been accepted that the classic MBD injures the center part of the corpus callosum, sparing the dorsal and ventral layers.[2] In addition, it is widely believed that extensive lesions indicate a worse prognosis.[3] Articles commonly report that MBD may also cause lesions at sites other than the corpus callosum.[4] To the best of our knowledge, a case with extracallosal lesions involving bilateral medipeduncle is rare.

A 48-year-old man was admitted to our department with repeated generalized seizures for more than 6 months. According to his family, these episodes lasted for approximately 2–3 minutes. The frequency of the seizures and their precipitating factors were unknown. After waking up, he became tired and started the clonic movements heralding the seizure but did not vomit or have bladder incontinence. The patient had a 20-year history of alcoholism, averaging more than 250 ml per day. On admission, the neurological examination revealed an intact cognition with a slurred speech. His pupils were equal in size and reactive to light and accommodation. His eye movements were normal without nystagmus. He had no VIIth or XIIth nerve palsy. The muscle strength of the patient's extremities was grade 5, with a normal muscle tone. The patient had no sensory disturbance, and his physiological reflexes were intact and normal.

Cerebral magnetic resonance imaging indicated abnormal signals in bilateral medipeduncle and the corpus callosum [Figure 1]a,[Figure 1]b,[Figure 1]c,[Figure 1]d,[Figure 1]e,[Figure 1]f. Laboratory tests showed a glutamic–pyruvic transaminase value of 95.2 U/L and a glutamic–oxalacetic transaminase value of 96.0 U/L. The patient did not undergo a liver ultrasound. Routine blood, kidney function, blood lipid, and blood coagulation tests indicated no overt abnormality. He did not undergo a lumbar puncture.
Figure 1: (a) T1 weighted imaging (T1WI): Hypointensity of the splenium of corpus callosum; (b) T2-weighted imaging (T2WI): Hyperintensity of the genu of the corpus callosum; (c) Fluid attenuated inversion recovery (FLAIR): Hypointensity of splenium of the corpus callosum; (d) Diffusion weighted imaging (DWI): Hyperintensity of splenium of the corpus callosum; (e) FLAIR: Hyperintensity of bilateral medipeduncle; (f) DWI: Hyperintensity of bilateral medipeduncle

Click here to view


His diagnosis was MBD. He received a large dose of B-complex vitamins, piracetam, and sodium valproate. He was discharged 8 days later with normal cognition and vital signs. At follow-up 3 months later, he reported that he had changed his job because of his clumsiness.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Navarro JF, Noriega S. Marchiafava-Bignami disease. Rev Neurol 1999;28:519-23.  Back to cited text no. 1
[PUBMED]    
2.
Hillbom M, Saloheimo P, Fujioka S, Wszolek ZK, Juvela S, Leone MA. Diagnosis and management of Marchiafava-Bignami disease: A review of CT/MRI confirmed cases. J Neurol Neurosurg Psychiatry 2014;85:168-73.  Back to cited text no. 2
[PUBMED]    
3.
Namekawa M, Nakamura Y, Nakano I. Cortical involvement in Marchiafava-Bignami disease can be a predictor of a poor prognosis: A case report and review of the literature. Intern Med 2013;52:811-3.  Back to cited text no. 3
[PUBMED]    
4.
Kawarabuki K, Sakakibara T, Hirai M, Yoshioka Y, Yamamoto Y, Yamaki T. Marchiafava-Bignami disease: Magnetic resonance imaging findings in corpus callosum and subcortical white matter. Eur J Radiol 2003;48:175-7.  Back to cited text no. 4
[PUBMED]    


    Figures

  [Figure 1]



 

Top
Print this article  Email this article
   
Online since 20th March '04
Published by Wolters Kluwer - Medknow