title: Diagnosis and management of Marchiafava-Bignami disease: a review of CT/MRI confirmed cases.
abstract: OBJECTIVE
  Marchiafava-Bignami disease (MBD) is a rare condition mainly associated with alcoholism, although it may be mimicked by several other disorders that cause corpus callosum lesions. Our objective was to identify helpful features for differential diagnosis and assess whether any treatment can be recommended.
  
  
  METHODS
  We reviewed 122 reports containing data on 153 subjects with confirmed MBD that was associated with either alcoholism or malnutrition, and 20 reports with data on 53 subjects with conditions mimicking MBD. All the cases had been verified antemortem by brain imaging. Unconditional logistic regression was used to demonstrate factors that were associated with the outcome of MBD.
  
  
  RESULTS
  The mimicking conditions were differentiated from MBD by the occurrence of solitary and rapidly disappearing splenial lesions; fewer signs and symptoms with exception of seizures, hemiparesis and tetraparesis; nystagmus; and rapid and complete recovery. MBD occurred most frequently among alcoholics, but it was also reported in 11 non-alcoholics (7.2% of all the MBD cases). A better outcome was observed among those who were treated within 2 weeks after onset of symptoms with parenteral thiamine (p=0.033).
  
  
  CONCLUSIONS
  As thiamine deficiency is frequently associated with alcoholism, malnutrition and prolonged vomiting; we recommend prompt treatment of MBD with parenteral thiamine in such subjects. Recovery should be followed by repeated neuropsychological and MRI examinations, preferably using diffusion tensor imaging.
authors: Department of Neurology, Oulu University Hospital, , Oulu, Finland.
authors: Matti
authors: M
authors: Hillbom
authors: Pertti
authors: P
authors: Saloheimo
authors: Shinsuke
authors: S
authors: Fujioka
authors: Zbigniew K
authors: ZK
authors: Wszolek
authors: Seppo
authors: S
authors: Juvela
authors: Maurizio A
authors: MA
authors: Leone
mesh_terms: D000437:Alcoholism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D003337:Corpus Callosum / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D054319:Marchiafava-Bignami Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D064847:Multimodal Imaging; D059906:Neuroimaging; D011379:Prognosis; D013256:Steroids / Q000627:therapeutic use; D013831:Thiamine / Q000627:therapeutic use*; D013832:Thiamine Deficiency / Q000150:complications / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D013256:Steroids; D013831:Thiamine
keywords: Alcohol-Related Problems; Clinical Neurology; Consciousness; Mental Retardation; Neuropsychiatry
references: Presse Med. 2010 Sep;39(9):990-3
references: 20537852
references: Emerg Radiol. 2008 Mar;15(2):137-40
references: 17828562
references: J Neuroimaging. 2006 Jul;16(3):281-5
references: 16808832
references: Eur J Neurol. 2010 Dec;17(12):1408-18
references: 20642790
references: Neurology. 2005 Aug 9;65(3):475-7
references: 16087921
references: Psychiatry Res. 2007 Nov 15;156(2):181-4
references: 17933499
references: Clin Neuropathol. 1984 Nov-Dec;3(6):231-6
references: 6440723
references: N Z Med J. 2006 Oct 27;119(1244):U2280
references: 17072355
references: J Neurol. 2003 Jun;250(6):758-60
references: 12862034
references: Can J Neurol Sci. 2010 Jan;37(1):138-40
references: 20169791
references: No To Shinkei. 2000 Jul;52(7):633-7
references: 10934726
references: Ann Indian Acad Neurol. 2012 Apr;15(2):151-7
references: 22566735
references: J Clin Neurosci. 2009 Jun;16(6):811, 859
references: 19548340
references: No To Shinkei. 2001 Jul;53(7):669-71
references: 11517494
references: AJNR Am J Neuroradiol. 2005 Mar;26(3):670-3
references: 15760886
references: J Neurol. 2004 Sep;251(9):1050-9
references: 15372245
references: Behav Brain Res. 1994 Oct 20;64(1-2):219-28
references: 7840888
references: Neuroradiology. 2005 Jul;47(7):520-4
references: 15918025
references: Neurology. 1978 Mar;28(3):290-4
references: 415261
references: J Neuroimaging. 2008 Apr;18(2):188-90
references: 18318682
references: J Neural Transm Park Dis Dement Sect. 1994;8(1-2):131-7
references: 7893375
references: AJNR Am J Neuroradiol. 2010 Sep;31(8):1506-7
references: 20019108
references: Neurologist. 2011 Jul;17(4):213-7
references: 21712668
references: AJNR Am J Neuroradiol. 1999 Aug;20(7):1249-51
references: 10472981
references: Tohoku J Exp Med. 1997 Jun;182(2):175-9
references: 9261936
references: Brain. 1961 Jun;84:212-30
references: 13717887
references: Indian J Radiol Imaging. 2010 Nov;20(4):254-7
references: 21423898
references: J Neurol Sci. 1994 May;123(1-2):2-5
references: 8064315
references: Neuroradiology. 2007 Jul;49(7):541-4
references: 17522852
references: J Neurol Neurosurg Psychiatry. 1993 Sep;56(9):1027-32
references: 8410028
references: Neuroradiology. 2000 Nov;42(11):795-802
references: 11151683
references: AJNR Am J Neuroradiol. 2003 Feb;24(2):249-53
references: 12591642
references: J Neuropsychiatry Clin Neurosci. 2011 Spring;23(2):E28
references: 21677215
references: Eur J Radiol. 2003 Nov;48(2):175-7
references: 14680909
references: J Neuroimaging. 2005 Oct;15(4):373-5
references: 16254404
references: Arch Neurol. 1991 Sep;48(9):986-8
references: 1953424
references: Eur Radiol. 2006 Apr;16(4):905-14
references: 16284771
references: Neurol India. 2009 Sep-Oct;57(5):644-8
references: 19934569
references: Epilepsia. 2005 Oct;46(10):1633-6
references: 16190935
references: Yonsei Med J. 2007 Apr 30;48(2):321-4
references: 17461534
references: Pathology. 1979 Apr;11(2):241-9
references: 460949
references: Neuropsychiatry Neuropsychol Behav Neurol. 2000 Jan;13(1):67-76
references: 10645739
references: Radiol Med. 2007 Sep;112(6):921-35
references: 17885738
references: Rev Neurol (Paris). 1996 Jan;152(1):47-50
references: 8729397
references: Eur J Neurol. 2006 Jul;13(7):749-53
references: 16834705
references: J Neuroimaging. 2011 Apr;21(2):e1-14
references: 18681931
references: Cortex. 2012 Jan;48(1):36-45
references: 21663900
references: Case Rep Neurol. 2010 Mar 23;2(1):19-23
references: 20689630
references: No To Shinkei. 2004 May;56(5):425-8
references: 15279201
references: Lancet. 1999 May 8;353(9164):1584
references: 10334258