Reversible splenial lesion syndrome in the patient with Marchiafava Bignami disease

초록

Background & Significance: Marchiafava Bignami disease is one of a rare disease characterized by the damage of the corpus callosum associated with chronic ethanol intake, and occasionally occurs in chronically malnour?? ished state, despite nonalcoholics. Clinical manifestation of Marchiafava Bignami disease is various and nonspecific and includes difficult walking, paraparesis, altered mental status, seizure, and split??brain syndrome. Reversible splenial lesion syndrome is defined as clinico??radiological syn?? drome and usually shows transient localized lesions in the splenium of the corpus callosum on magnetic resonance imaging (MRI). This disease has been reported to be associated with variable entities like seizures, septic en?? cephalitis, metabolic encephalopathy, eclampsia, Marchiafava??Bignami dis?? ease, and neoplasm. The most common neurological symptoms of splenic lesion syndrome include delirious behavior and drowsiness. Here, we show the case of Marchiafava Bignami disease, initially mimicking reversible sple?? nial lesion syndrome. Case: A 34??year??old woman was admitted to the Emergency Room with complain of slight drowsiness, truncal ataxia and dizziness. She had the medical history of chronic alcohol abuse related to alcoholic fits, alcoholic tremor and delirium tremens. She also had associa?? tive visual agnosia like progopagnosia and simultagnosia. Physical exami?? nation revealed a cebellar ataxia like dysmetria, tremor and truncal ataxia. The score of minimental status examination was 27. Pupils showed normal size with normal reactivity to light, but had no evidence of K??F ring. No meningeal signs were present. The patient did not suffer from diabetes, hy?? pertension, seizure, or fever. Routine blood tests revealed high serum level of hepatic enzyme and LDL with slight decreased serum level of vitamine B12. Cerebrospinal fluid studies, evoked potentials and electroencephalo?? graphic examination indicated no si