Marchiafava-Bignami Disease in a Patient With Polysubstance Use Disorder

TL;DR

This paper presents a rare neurological case of Marchiafava-Bignami disease in a young man with a history of polysubstance abuse.

Contribution

The novelty lies in highlighting MBD occurrence in the context of polysubstance use, not just chronic alcoholism.

Findings

MBD was diagnosed in a 27-year-old with polysubstance use disorder through MRI showing corpus callosum demyelination.

The case expands understanding of MBD beyond chronic alcoholism to include polysubstance abuse as a potential cause.

Abstract

Marchiafava-Bignami disease (MBD) is a rare demyelinating disease associated with chronic alcohol use and/or malnutrition leading to vitamin deficiency. Clinical presentation is diverse and can range from mild neurological deficits of dysarthria and confusion to severe symptoms such as coma or even death. Diagnosis is made using imaging modalities including magnetic resonance imaging (MRI) and computed tomography (CT) with the rise in technological advances placing MRI as the most sensitive and specific imaging technology for diagnosis. Classic MBD imaging demonstrates demyelination and necrotic damage of the corpus callosum. While MBD is a well-documented neurologic complication of chronic alcoholism, its occurrence and presentation in the context of concurrent polysubstance abuse remain underexplored. We outline the case of a 27-year-old male with polysubstance use disorder presenting with subacute neurological deterioration and demyelination of the splenium of the corpus callosum.

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