A Case of Marchiafava-Bignami Disease with Abnormal SPECT Findings

ABSTRACT

Marchiafa-Bignami disease(MBD) is a rare complication of chronic alcoholism and is pathologically characterized by a symmetrical primary demyelination of the corpus callosum with or without focal necrosis. The clinical features of the disease are quite variable, and the course is usually progressive and fatal. We present a case with characteristic clinical features and imaging findings, including SPECT, of MBD. A 51-year-old man was admitted due to mental confusion, violent behavior, and slowness of motion for 2 months. He had been a heavy alcoholic for about 20 years. He was in a stuporous state for 1 week beginning 2 weeks after his admission.. He then showed alertness but was still in a mute state. His cooperation and responses to noxious stimuli were very poor. A brain MRI showed focal cystic change in the enlarged corpus callosum and diffused high-signal intensity in the subcortical white matter, thalamus, and corpus callosum in T2WI. 99mTc-ECD SPECT revealed diffusely decreased cerebral perfusion in both frontal, temporal and pari-eto-occipital lobes.