title: Mutism Caused by Severe Demyelination in a Patient With Marchiafava-Bignami Disease.
abstract: BACKGROUND
  Marchiafava-Bignami (MB) disease is a rare disorder that causes primary degeneration of the corpus callosum. It is associated with chronic alcohol consumption caused by either a toxic or nutritional etiology.
  
  
  METHODS
  We report a case of a 54-year-old woman who presented to our emergency department with complete mutism caused by MB disease that completely resolved with intravenous thiamine and dextrose therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians frequently encounter patients with alcohol abuse and its complications. We report a rare presentation of a potential alcohol-related spectrum disease that may be encountered by an emergency physician. Early diagnosis and prompt management are critical to potentially reversing the disease, and this case shows the importance of including this disease in the differential diagnosis in patients with speech difficulty and alcohol abuse.
authors.affiliation: Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Raman
authors.initials: R
authors.lastname: Mehrzad
authors.affiliation: Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut; David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Ho
mesh_terms: D000437:Alcoholism / Q000150:complications*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D054319:Marchiafava-Bignami Disease / Q000150:complications* / Q000000981:diagnostic imaging; D008875:Middle Aged; D009155:Mutism / Q000188:drug therapy* / Q000209:etiology*; D013831:Thiamine / Q000627:therapeutic use*; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D014803:Vitamin B Complex; D005947:Glucose; D013831:Thiamine
keywords: Marchiafava–Bignami disease; demyelination; mutism