MARCHIAFAVA-BIGNAMI DISEASE IN A PATIENT WITH CHRONIC ALCOHOLISM: A CASE REPORT OF NEUROPSYCHIATRIC SYMPTOMS AND RECOVERY FOLLOWING ALCOHOL CESSATION AND NUTRITIONAL SUPPLEMENTATION

Authors

  • Muhammad Sohail Ajmal Ghoauri Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur Pakistan
  • Nauman Ismat Butt Chaudhary Muhammad Akram Teaching and Research Hospital, Azra Naheed Medial College, Superior University Lahore Pakistan
  • Hamid Mehmood Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur Pakistan
  • Barak Waris Chaudhary Muhammad Akram Teaching and Research Hospital, Azra Naheed Medial College, Superior University Lahore Pakistan
  • Imania Khizar Chaudhary Muhammad Akram Teaching and Research Hospital, Azra Naheed Medial College, Superior University Lahore Pakistan

Keywords:

Marchiafava-Bignami disease, Thiamine, Alcohol abuse, Corpus callosum, MRI Brain

Abstract

Marchiafava-Bignami disease is a rare neurological disorder associated with chronic alcohol abuse, characterized by the demyelination of the corpus callosum. We report a case of a 40-year-old male who presented to Department of Neurology, Bahawal Victoria Hospital, Bahawalpur in September 2024 with a long history of chronic alcohol abuse and hypertension presenting to the emergency department with progressively worsening severe agitation, irritability and refusal to eat over a period of 8 months. The patient was earlier misdiagnosed as a case of acute ischemic stroke and was treated with antiplatelets, statins and psychiatric medications. Despite ongoing psychiatric treatments, the symptoms continued to worsen; thus, suspicion arose regarding underlying psychiatric or neurological disorders. Examination did not reveal focal neurological deficits, and routine blood work, including liver and renal function tests, was unremarkable. Brain MRI, done in September 2024, showed T2/FLAIR hyperintensity and diffusion restriction of the splenium of the corpus callosum, indicating the diagnosis of MBD. Based on clinical and MRI findings, a final diagnosis of MBD Type B was made. Thiamine, vitamin B complex and folic acid were prescribed, and he was counselled on strict cessation of alcohol. After consultation with psychiatry, antipsychotics were started. There was a significant improvement in his condition following these interventions, and repeat MRI showed resolution of abnormalities by June 2025.

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Published

2026-05-21

How to Cite

1.
Ghoauri MSA, Butt NI, Mehmood H, Waris B, Khizar I. MARCHIAFAVA-BIGNAMI DISEASE IN A PATIENT WITH CHRONIC ALCOHOLISM: A CASE REPORT OF NEUROPSYCHIATRIC SYMPTOMS AND RECOVERY FOLLOWING ALCOHOL CESSATION AND NUTRITIONAL SUPPLEMENTATION. J Ayub Med Coll Abbottabad [Internet]. 2026 May 21 [cited 2026 May 21];37(4). Available from: https://www.jamc.ayubmed.edu.pk/index.php/jamc/article/view/14856

Issue

Vol. 37 No. 4 (2025): 37-4

Section

CASE REPORT

License

Copyright (c) 2026 Muhammad Sohail Ajmal Ghoauri, Nauman Ismat Butt, Hamid Mehmood, Barak Waris, Imania Khizar

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