Marchiafava-Bignami: Clinical Case Description

¹Irmandade Santa Casa de Arapongas, Rua Calu, 155, Arapongas PR, Brazil

^2,3Centro Universitário de Valença – UNIFAA, Rua sargento Vitor Hugo, 161, Valença RJ, Brazil

*Corresponding author: Milton CR Medeiros, Irmandade Santa Casa de Arapongas, Rua Calu, 155, Arapongas PR, Brazil, Tel: 43999728197, E-mail: [email protected]

Received Date: August 19, 2024

Publication Date: August 29, 2024

Citation: Medeiros MCR, et al. (2024). Marchiafava-Bignami: Clinical Case Description. Neuro Research. 6(1):19.

Copyright: Medeiros MCR, et al. © (2024).

ABSTRACT

Introdution: Marchiafava-Bignami disease is a rare disorder of demyelination and necrosis of the corpus callosum and the near subcortical white matter that is especially predominant in chronic alcoholism. It was discovered in 1903 by Italian pathologists Ettore Marchiafava and Amico Bignami. They described a case that presented necrosis of their corpus callosum on autopsy. Just a few cases have been described in non-drinking patients, suggesting that alcohol is the main, but not the only responsible for these disease. Its development is also possible in chronic malnutrition. The main pathophysiological hypothesis is the deficiency of B complex vitamins. Replacement of B complex vitamins guides the current treatment, although there is not always a significant improvement in the clinical picture, as happened in the case described. Case Presentation: male patient, 68 years old. Chronic alcoholic with daily consumption of distilled drinks. Since two years ago he had been experiencing progressive cognitive decline across multiple domains. On physical examination, he presented mini mental status exam 18 (spatial disorientation, recall memory and language), gait disturbance and bilateral pyramidal signs. He received intravenous hydration, calories and B-complex vitamins, with only slight improvement after 7 days of hospitalization. MRI showed hyperintense signal on T2 affecting the corpus callosum. After one month of outpatient follow-up, the patient showed a slight improvement in gait, but maintained cognitive impairment. Discussion: Marchiafa-Bignami disease should be remembered in chronic alcoholics with non-specific neurodegenerative symptoms. History, physical examination and MRI can lead to the diagnosis, guiding treatment. Final Comments: chronic alcoholic patients with a non-specific neurodegenerative condition must have Marchiafava-Bignami disease on the list of differential diagnoses. History, physical examination and magnetic resonance imaging define the diagnosis, allowing prompt treatment. Unfortunately, in the case described, even with appropriate therapeutic measures, there was no good evolution. Probably due to the significant extent of the lesion in the corpus callosum.

Keywords: Marchiafava-Bignami, Chronic Alcoholism, Corpus Callosum, Complex B Vitamin