Initially Normal MRI, Delayed Splenial Lesion in Marchiafava-Bignami Disease

Area of Science:

• Neurology
• Radiology
• Nutritional Neuroscience

Background:

• Marchiafava-Bignami disease (MBD) is a rare neurological disorder.
• It is primarily associated with chronic alcohol consumption and subsequent thiamine deficiency.
• Early diagnosis can be challenging due to non-specific initial symptoms and imaging findings.

Purpose of the Study:

• To highlight the potential for normal early MRI findings in Marchiafava-Bignami disease.
• To emphasize the importance of repeat neuroimaging in at-risk populations.
• To underscore the diagnostic utility of recognizing evolving splenial lesions.

Main Methods:

• Review of clinical cases and neuroimaging findings in patients with suspected MBD.
• Correlation of MRI results with clinical presentation and nutritional status.
• Analysis of temporal changes in splenial lesions on serial imaging.

Main Results:

• Initial MRI scans in MBD patients may exhibit normal or subtle findings.
• Splenial lesions, characteristic of MBD, can manifest or progress on repeat imaging.
• Delayed diagnosis is often linked to the initial absence of definitive MRI abnormalities.

Conclusions:

• Early MRI findings in Marchiafava-Bignami disease can be misleadingly normal.
• Serial MRI is essential for diagnosing MBD in individuals with alcohol use disorder or thiamine deficiency risk.
• Prompt recognition of developing splenial lesions on follow-up imaging is critical for timely intervention and improved outcomes.