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Table of Contents    
NEUROIMAGES
Year : 2019  |  Volume : 67  |  Issue : 4  |  Page : 1169

Marchiafava-Bignami Disease in a Patient with No Alcohol Abuse


Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

Date of Web Publication10-Sep-2019

Correspondence Address:
Dr. Satoshi Sera
Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-Ku - 730-8518, Hiroshima
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.266247

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How to cite this article:
Sera S, Ichiba T. Marchiafava-Bignami Disease in a Patient with No Alcohol Abuse. Neurol India 2019;67:1169

How to cite this URL:
Sera S, Ichiba T. Marchiafava-Bignami Disease in a Patient with No Alcohol Abuse. Neurol India [serial online] 2019 [cited 2019 Sep 23];67:1169. Available from: http://www.neurologyindia.com/text.asp?2019/67/4/1169/266247





  Case Presentation Top


A 27-year-old man with anorexia nervosa presented to our emergency department with acute dysarthria and the inability to walk. He had no history of alcohol abuse. He spoke nonsense words and appeared restless. A physical examination revealed an increase in muscle tone of both upper arms but no sign of meningeal irritation. His laboratory values on admission disclosed normal blood glucose and ammonia. Brain magnetic resonance imaging (MRI) on admission showed hyperintensity at the splenium of the corpus callosum in a diffusion-weighted image [Figure 1]a. After hospitalization for nutritional supplementation, his neurological abnormality gradually improved and MRI on day 5 showed resolution of hyperintensity at the splenium of the corpus callosum [Figure 1]b. He was discharged after being hospitalized for 8 days.
Figure 1: Brain MRI on admission showed hyperintensity at the splenium of the corpus callosum in DWI (a). Brain MRI on the fifth hospital day showed resolution of hyperintensity at the splenium of the corpus callosum in DWI (b)

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Marchiafava-Bignami disease is a rare disorder of demyelination and necrosis of the corpus callosum and is usually associated with alcohol abuse.[1],[2],[3] It may progress to coma and death without adequate treatment. The neurologic complications of alcohol such as Wernicke encephalopathy and Korsakoff syndrome are well-known disorders, so we usually perform brain MRI in patients with neurological symptoms with alcohol abuses, which may lead to the correct diagnose of Marchiafava-Bignami disease. On the other hand, a few cases of Marchiafava-Bignami disease have been described in non-alcohol abusers suggesting to be nutritional etiology.[4] Various vitamin deficiencies and malnutrition have been linked with Marchiafava-Bignami disease. Therefore, patients with neurological symptoms who not only have a history of alcohol abuse but also have malnutrition should be examined carefully because appropriate nutritional support can prevent the progression of Marchiafava-Bignami disease.

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There are no conflicts of interest.



 
  References Top

1.
Menon B, Chowdary MS, Bindu AH, Rani U. Marchiafava-Bignami disease-An alcohol related medical emergency. Int J Epilepsy 2015;2:51-3.  Back to cited text no. 1
    
2.
Tembey RA, Karnik A, Mani SA. MR imaging in the diagnosis of Marchiafava-bignami syndrome. Neurol India 2019;67:321-3.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Malhotra R, Chopra T, Al Nimri O. Marchiafava Bignami disease. Neurol India 2017;65:1440-1.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Celik Y, Temizoz O, Genchellac H, Cakir B, Asil T. A non-alcoholic patient with acute Marchiafava-Bignami disease associated with gynecologic malignancy: Paraneoplastic Marchiafava-Bignami disease? Clin Neurol Neurosurg 2007;109:505-8.  Back to cited text no. 4
    


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