title: Marchiafava-Bignami Disease with frontal cortex involvement and late onset, long-lasting psychiatric symptoms: a case report.
abstract: To describe the case and management of a patient with Marchiafava-Bignami Disease (MBD) with frontal cortical lesions, no specific symptom at first referral to the Emergency Room, and late onset of atypical psychiatric symptoms.
  
  
  
  We report the case of a 44-year-old patient with a history of chronic alcohol abuse, eventually diagnosed with MBD.
  
  
  
  Magnetic Resonance showed lesions in the splenium and the body of corpus callosum and bilateral lesions of the frontal cortex. The patient showed late-onset atypical psychiatric
  symptoms which were drug resistant.
  
  
  
  The case we describe seems to support the existing few ones describing cortical involvement in MBD, which suggest that this is associated with a poorer prognosis. Psychiatric symptoms may be challenging to treat because of drug resistance.
  
  
  
  The involvement of psychiatrists together with neurologists and radiologists, with a consultation-liaison approach proved important for the achievement of diagnosis and of the most appropriate management and treatment for this patient.
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Gramaglia
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Feggi
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Vecchi
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Di Marco
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Venesia
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Delicato
authors.affiliation: AOU Maggiore della Carità, Novara, Italy.
authors.forename: Nunzia
authors.initials: N
authors.lastname: Chieppa
authors.affiliation: Institute of Neurology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Fabiola
authors.initials: F
authors.lastname: De Marchi
authors.affiliation: AOU Maggiore della Carità, Novara, Italy - Institute of Neurology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cantello
authors.affiliation: Institute of Psychiatry, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy - AOU Maggiore della Carità, Novara, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Zeppegno
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications; D000855:Anorexia / Q000209:etiology; D014150:Antipsychotic Agents / Q000627:therapeutic use; D057210:Delayed Diagnosis; D018450:Disease Progression; D004351:Drug Resistance; D004630:Emergencies; D017809:Fatal Outcome; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054319:Marchiafava-Bignami Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology* / Q000523:psychology; D059906:Neuroimaging; D011604:Psychoses, Alcoholic / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D014150:Antipsychotic Agents