Marchiafa-Bignami-syndrome. Extrapontine myelinolysis in chronic alcoholism

Citation
S. Gabriel et al., Marchiafa-Bignami-syndrome. Extrapontine myelinolysis in chronic alcoholism, NERVENARZT, 70(4), 1999, pp. 349-356
Citations number
35
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Neurology
Journal title
NERVENARZT
ISSN journal
0028-2804 → ACNP
Volume
70
Issue
4
Year of publication
1999
Pages
349 - 356
Database
ISI
SICI code
0028-2804(199904)70:4<349:MEMICA>2.0.ZU;2-A
Abstract
Until now,the pathogenesis of Marchiafava-Bignami disease, an extrapontine myelinolysis, is unknown. Accept an abuse of alcohol for many years additio nal metabolic and vascular disturbances are supposed. The early performance of magnetic resonance imaging in patients with a sudden encephalopathy and history of alcoholism is essential for an assessment of the diagnosis. The bilateral lack of transcallosal inhibition a parameter for the integrity o f the transcallosal connections between motor cortices is the consequence o f the axonal degeneration of transcallosal fibers. Clinical and neuroradiol ogical features of three patients with extrapontine myelinolysis are report ed and possible etiologies of the complex disease are discussed. In two cas es a severe alcohol abuse was present with the typical picture of the March iafava-Bignami disease. In a third patient an intoxication with methanal wa s present with a similar clinical picture. Although severe neurological disturbances were initially apparent in the pa tients, during the follow-up there was a significant amelioration of the cl inical course under a high-dose vitamin B supplementation.