Marchiafava-Bignami disease: A rare entity in chronic alcoholic with a poor prognosis

Marchiafava-Bignami disease (MBD) is a rare neurological disorder characterized by demyelination and necrosis of the corpus callosum, often seen in people with alcohol use disorder, and chronic malnutrition leads to hypovitaminosis (vitamin B1 deficiency), decreased synthesis of neurotransmitters, failure to synthesize glutamine, and decreased myelin synthesis, leading to decreased self-defense against oxidative stress. This case report describes a 32-year-old man with a complex medical history, including alcohol dependence, who presented with neurological symptoms such as altered sensorium and convulsion. Diagnostic imaging via magnetic resonance imaging (MRI) confirmed MBD. Given the patient's nutritional status, treatment focused on parenteral B vitamin supplementation, particularly thiamine and other B vitamins, which are critical for neurological function. The patient showed no significant improvement in neurological symptoms following vitamin therapy, which highlights a poor prognosis in chronic alcoholism.