Marchiafava-Bignami Disease
It is a rare neurological complication of chronic alcoholism, with pathognomonic hallmark of corpus callosum demyelination⠀ ⏩The main pathologic changes include symmetrical demyelination and necrosis of the central part of the corpus callosum, with relative sparing of dorsal and ventral layers. ✅Rarely, other structures of the CNS like optic chiasm and tracts, putamen, anterior commissure, cerebellar peduncles and, cortical gray matter and U fibers may be involved ⏩The corpus callosum appears hypoattenuated on CT, The corpus callosum appears hyperintense on T2-WI, hypointense on T1-weighted images and proton density-weighted MR images during the acute phase ⏩The recent clinical and neuroradiological classification - ✅Type A: acute to subacute onset of consciousness impairment, pyramidal tract signs, limb hypertonia, seizures, hyperintense swelling of the corpus callosum on T2-weighted MR sequences and is associated with poor prognosis. ✅Type B: normal or slightly impaired level of consciousness, dysarthria, gait disturbance, signs of interhemispheric disconnection and hyperintense lesions on T2-weighted MR sequences partially involving the corpus callosum. It has favourable prognosis. ⏩In this case diagnosis was made on the basis of chronic alcoholism and radiological features showing characteristic sandwich sign which are seen as low signal intensity in T1WI, high signal intensity in T2WI ⏩It may present in various clinical forms. ✅Acute disease may present with seizures, impairment of consciousness, and rapid death. ✅Subacute disease present with variable degrees of mental confusion, dysarthria, behavioral abnormalities, memory deficits and impairment of gait. ✅Chronic disease, is characterized by mild dementia which is progressive over years. ⏩Treatment is usually empirical and consists of multivitamins, corticosteroids, stabilization of plasma glucose, and supportive care. Early diagnosis and prompt treatment are critical in reversing the early stage of the disease. By: https://www.instagram.com/p/CapALsKBU7S/?igshid=YmMyMTA2M2Y=