Marchiafava-Bignami Disease: A Less Known Neurological Complication of Alcoholism

Abstract

Marchiafava-Bignami disease (MBD) is a disorder associated with chronic alcohol consumption and characterized by demyelination and necrosis of the corpus callosum. Patients may have reduced consciousness, psychotic symptoms, apathy, hemiparesis, ataxia and coma. Although some cases of recovery have been reported, the outcome is poor, with disability or dead. We reported a case of a 56-year-old woman with chronic alcoholism admitted to our hospital with impaired consciousness and a history of gait disturbance. On examination, she was in a coma, with increased muscle tone and left arm paresis. Laboratory studies showed a folic acid deficiency and the CT scan was normal. Magnetic resonance imaging revealed lesions in periventricular white matter and the entire corpus callosum with restriction of water diffusion consistent with the diagnosis of MBD. Despite treatment with B vitamin complex, the patient died. Coma and radiological involvement of the entire corpus callosum are compatible with type A MBD and associated with poor prognosis. Although being a rare alcoholism complication, it should not be forgotten since an early diagnosis and prompt supportive therapy may enable a better outcome.

Assessment of Vitamin B1 and B12 Deficiencies in Patients with Alcohol Withdrawal Syndrome

“…Symptoms include psychosis, depression, apathy, hemiparesis, and apraxia and in severe cases coma and death. Researchers from Portugal, Iran, India noted that in patients diagnosed with Marchiafava-Bignami disease serum vitamin B12, and folic acid (vitamin B9) levels were decreased and patients started to feel better with the administration of treatments containing vitamin B 4,39,40 .…”