Marchiafava-bignami disease

[GarryDrold]

Marchiafava-Bignami disease is a rare demyelination of the corpus callosum that occurs in patients with chronic alcohol use disorder, predominantly men.
Pathology and circumstances link this disorder to osmotic demyelination syndrome (previously called central pontine myelinolysis), of which it may be a variant. In Marchiafava-Bignami disease, the speed of onset and the degree of physical findings vary.
Patients can present with acute, subacute, or chronic onset of mental status change varying from lethargy to coma, seizure, ocular movement dysfunction, memory loss, and gait disturbance.
Some patients recover over several months. Patients who present in coma and stupor have a mortality rate of about 20%.
There is no specific treatment for Marchiafava-Bignami disease, but supportive care typically includes vitamin supplementation (particularly of thiamin, folate, and other B vitamins) and correction of malnutrition.
(See also Alcohol Toxicity and Withdrawal as well as Alcohol Use Disorder and Rehabilitation.)