Marchiafava-Bignami Disease: A Rare Association With Dysdiadochokinesia and Ataxic Gait

Marchiafava-Bignami disease (MBD) is a rare neurological disorder characterized by demyelination and necrosis of the corpus callosum. The non-specific signs and symptoms associated with MBD including dysarthria, impaired walking, pyramidal signs, primitive reflexes, seizures, incontinence, sensory s...

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Published inCurēus (Palo Alto, CA) Vol. 15; no. 7; p. e41492
Main Authors Abouibrahim, Mahmoud, Agarwal, Ansh, Ottih, Ugochinyere, Ravendran, Kapilraj, Bista, Galaxy, Zafar, Mansoor, Hovagim, Garabedyan, Hacikurt, Kadir
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 07.07.2023
Cureus
Subjects
Alcoholism
Ataxia
Atrophy
Blood
Case reports
Cerebrospinal fluid
Cytotoxicity
Dysarthria
Edema
Electrolytes
Emergency medical care
Gait
Hemoglobin
Immunoglobulins
Internal Medicine
Magnetic resonance imaging
Malnutrition
Neurological disorders
Neurology
Pathology
Patients
Physical Medicine & Rehabilitation
Tomography
marchiafava-bignami disease
magnetic resonance imaging
ataxic gait
corpus callosum
dysdiadochokinesia
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Summary:Marchiafava-Bignami disease (MBD) is a rare neurological disorder characterized by demyelination and necrosis of the corpus callosum. The non-specific signs and symptoms associated with MBD including dysarthria, impaired walking, pyramidal signs, primitive reflexes, seizures, incontinence, sensory symptoms, gaze palsies, and altered mental state result in a challenging diagnosis. Here, we report the case of a 64-year-old female presenting with dizziness, gait ataxia, and a history of recurrent falls for several months. Initial blood tests indicated anaemia, hypokalemia, hypomagnesemia, and mildly elevated inflammatory markers. Her presentation was initially attributed to a multifactorial aetiology, including a urinary tract infection, orthostatic hypotension, and electrolyte imbalances; however, on correction of reversible causes, her symptoms persisted. Moreover, further examination revealed right-hand dysdiadochokinesia. Subsequent brain MRI revealed fluid-attenuated inversion recovery hyperintensity within the corpus callosum and a right-sided pericallosal white matter hyperintensity. Neuro-radiology multidisciplinary team reported these findings consistent with MBD. Management with vitamin B supplementation was promptly initiated alongside alcohol cessation advice. She was also reviewed by physiotherapy teams. This case adds to the paucity of literature on MBD.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.41492