Clinical Analysis Of Alcohol-induced Marchiafava-Bignami Disease

Objective:To investigate the neuroimaging and semiologic characteristics of alcohol-induced Marchiafava-Bignami disease(MBD), so that more physicians can recognize this disease and make diagnosis without delay.Methods:We analyze the clinical materials of 4 MBD patients with chronic alcohol consumption admitted in our hospital recently.Results:4 patients were all chronic alcohol abusers who consumed white wine 300-800ml/d. Two cases of them suffered from acute onset of coma or stupor accompanied by frequent seizures, while the other two presented a subacute course without major impairment of consciousness but decrease of memory and dysarthria. Physical examination revealed that all patients were hypertonia but only one had pyramidal sign. MRI demonstrated a variable degrees of swelling of the corpus callosum with symmetric lesions located in the genu and splenium. These lesions are iso-hypointense on T1-weighted images and hyper-intense on T2-weighted images. Diffusion-weighed imaging(DWI) and fluid attenuated inversion recovery(FLAIR) showed bright signal intensities in the corresponding lesions. Extra corpus callosum lesions were detected in two patients who proceeded poor outcomes. While the other two patients whose lesions were limited within the corpus callosum got favorable outcomes.Conclusion:MBD is a rare alcohol-associated disorder characterized by demyelination of the corpus callosum. Clinical features vary but neuroimaging characteristics are found. MRI is an efficient method for early diagnosis. The impairment of consciousness and involvement of extra corpus callosum appears to be associated with a poorer prognosis.