A case report of acute Marchiafava-Bignami disease: a rare clinical entity in chronic alcoholism

  • Mohd Arif Abdul Malik Khiew Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia https://orcid.org/0000-0003-2052-3047
  • Abdul Hanif Khan Yusof Khan Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • Wei Chao Loh Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • Liyana Najwa Inche Mat Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • Peck Kee Chia Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • Wan Aliaa Wan Sulaiman Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • Fan Kee Hoo Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
  • Hamidon Basri Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
Keywords: alcoholics, case reports, corpus callosum, magnetic resonance imaging, Marchiafava-Bignami disease, Wernicke encephalopathy
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Abstract

Marchiafava‑Bignami disease (MBD) is a rare neurological disease often associated with a chronic consumption of alcohol and malnutrition, which is characterized by a demyelination and necrosis of the corpus callosum. We present a case of a 21-year-old male with chronic alcoholism who presented with an acute altered sensorium and seizure, which were initially treated as meningoencephalitis. His persistent poor Glasgow coma scale score and ideomotor recovery with encephalitic changes on his electroencephalogram prompted urgent magnetic resonance imaging (MRI) of his brain, which revealed extensive symmetrical hyperintensities in the corpus callosum. The diagnosis of MBD was made because of the typical MRI findings and after the exclusion of other possible diagnosis. The patient was promptly treated with a parenteral thiamine and showed a good recovery at 3 months follow-up. This case highlights the importance of diagnosing and recognizing MBD in a patient with chronic alcoholism as prompt treatment could prevent irreversible damage, which could carry high morbidity.

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Published
2021-02-05
How to Cite
1.
Khiew MAAM, Khan AHKY, Loh WC, Mat LNI, Chia PK, Sulaiman WAW, Hoo FK, Basri H. A case report of acute Marchiafava-Bignami disease: a rare clinical entity in chronic alcoholism. Med J Indones [Internet]. 2021Feb.5 [cited 2021Oct.21];30(2):152–6. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/4464
Section
Case Report/Series