A Case Report on Acute Marchiafava-Bignami Disease

Marchiafava-Bignami disease (MBD) is an uncommon yet fatal complication seen mostly among patients who are long-term consumers of alcohol and malnourished individuals. MBD is a complex neurodegenerative disorder, characterized primarily by the corpus callosum involvement in the form of necrosis, degeneration, or demyelination. It basically presents in acute, subacute, and chronic forms. The clinical spectrum varies from a mild progressive dementia in chronic forms to comatose state and mortality in acute forms. Clinicoradiological correlation helps in making the diagnosis at the earliest. Here, we present a case report of a 30-year-old young factory worker, who was a chronic alcohol consumer, and a known case of seizure disorder on regular antiepileptic drugs (AEDs) presented with acute onset altered sensorium, wherein differentials like viral encephalitis, AED toxicity, acute disseminated encephalomyelitis (ADEM), Wernicke’s encephalopathy, lead or methanol toxicity, or adult-onset hereditary leukodystrophy were ruled out to reach a clinicoradiological diagnosis of acute MBD. Apart from corticosteroids pulse and thiamine supplementation, the patient was hemodialyzed twice, which further helped in the clinical improvement and later radiological resolution with the resultant discharge of our patient. Acute MBD has a fatal outcome if undiagnosed and not treated at the earliest. Our report outlines a possible role of hemodialysis in treating acute MBD patients. Further, we found that radiological resolution comes later in comparison to clinical improvement.