Marchiafava‑Bignami Disease: The Importance of Early Diagnosis and Treatment by a Multidisciplinary Team

Abstract

Marchiafava‑Bignami disease is a rare condition associated with chronic alcohol consumption and/or malnutrition, characterized by demyelination of the corpus callosum, generally attributed to a deficiency in B complex vitamins. We report the case of a 34‑year‑old male with a 10‑year history of alcohol dependence who was admitted to the hospital, after having been found lying on the floor of his house, malnourished and with pressure ulcers on his chest and knees. On clinical observation he was found to be alert but mute. He followed some simple orders. Generalized spastic hypertonia was present. Magnetic resonance imaging showed demyelination of the corpus callosum, suggesting the diagnosis of Marchiafava‑Bignami disease. He was admitted to the Psychiatry Inpatient Unit and evaluated by a multidisciplinary team. He received thiamine, corticosteroids and rehabilitation. After a week, his speech was slurred but comprehensible and he could walk with aid; magnetic resonance imaging findings had improved. After three months in a Convalescence Unit, he was discharged with total autonomy.