Comprehensive neuropsychological findings in a case of Marchiafava-Bignami disease

Marchiafava-Bignami disease (MBD) is a rare complication associated with chronic heavy alcohol use, with case reports documenting a range of cognitive outcomes. Given the variability in MBD presentation and outcomes, milder cases may remain undiagnosed and few studies or case reports have presented a comprehensive neuropsychological profile of these patients. The objective of this case study was to describe the neuropsychological presentation and findings of a case of likely MBD.

The patient was a 46-year-old, African American female with a complex history of malnutrition and alcohol abuse presenting for outpatient neuropsychological evaluation. She was administered a comprehensive battery of neuropsychological tests as part of routine clinical care.

Neuropsychological data demonstrated severe deficits in executive functions, complex visuoconstruction, and motor dexterity, as well as an amnestic verbal and visual memory pattern.

Overall, data and the patient's initial presentation of acute behavioral change were consistent with some reports of cognitive and behavioral sequela of MBD. Additionally, the patient's history of chronic poor nutritional intake with exacerbation from chronic heavy alcohol use, and imaging findings of severe cerebral/corpus callosum white matter loss and bilateral frontoparietal atrophy, were highly suggestive of MBD.