Clinical Features And Imaging Characteristics Of Marchiafava-Bignami Disease Caused By Alcoholism

Objective To investigate the clinical features and imaging characteristics of patients with Marchiafava–Bignami disease caused by alcoholism.Methods This study included 10 patients with Marchiafava–Bignami disease hospitalized in Huaibei people’s hospital from November 2011 to December 2014.The clinical manifestations and imaging features and Electroencephalogram were collected and analyzed,data on cognitive functions evaluated by Montreal Cognitive Assessment(Mo CA),Mini-mental State Examination(MMSE)and Stroop Color-word Test were also analyzed.Follow-up of functional recovery were obtained from all the patients 3 to 18 months after discharge from hospital.Results1.Clinical features: All of the ten patients were male with a history of long-term and heavy alcohol consumption.The onset model of the disease varied among the included patients with acute onset for 4 cases,subacute onset for 3 cases and chronic onset for 3 cases.The clinical manifestations were consciousness impairment(4cases),psychological and behavior disturbance(3 cases),tremor(6 cases),increased muscle tone(4 cases),dysarthria(5 cases),ataxia(3cases),pyramidal sign(2 cases),seizure attack(2 cases)and visual hallucination(1cases).2.Neuroimaging characteristics: Cranial MRI showed abnormal signal in corpus callosum in all patients,affecting all parts of corpus callosum including the body,genu and splenium in 8 cases,the body and the splenium in 1 cases and the body and the genu in 1 case.The damage of corpus callosum in MRI displayed low signals in T1 weighted image and high signals in T2 weighted image as well as FLAIR image.The typical abnormal imaging in patients with acute or subacute onset was swelling of the corpus callosum,while in patients with chronic onset the MRI of corpus callosum showedtypical “sanwich-like sign”.3.EEG:normal in 4 cases,mildly abnormal in 2 cases,mild-moderately abnormal in3 cases.4.Cognitive function examination:Six patients completed the tests,other 4 patients were unable to perform the tests due to impaired consciousness.The scores of MMSE,Mo CA and Stroop test for the 6 patients fulfilling the tests are(24.33±1.63),(20.67±3.08)respectively and(23.10±5.44)second.5.Follow-up : Two patients remain unchanged in the daily life function and cognition compared to status upon discharge,6 patients showed almost full recovery and were able to live a normal life,1 patient’s condition deteriorated due to relapse of alcohol abuse,1 patient who asked to be discharged against advice died of pneumonia after long-term bedridden at home.Conclusion The degenerationof Marchiafava–Bignami disease is related with long-term chronic alcoholism,clinical manifestations of the lack of specificity,needing combined with the feature of imaging,headmagnetic resonance imaging has important value for the diagnosis of Marchiafava–Bignami disease.