Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Neurological Medicine
Volume 2013 (2013), Article ID 979383, 4 pages
http://dx.doi.org/10.1155/2013/979383
Case Report

Marchiafava-Bignami Disease in a Nonalcoholic Diabetic Patient

1Department of Neurology, Temple University School of Medicine, 3401 North Broad Street, Suite C525, Philadelphia, PA 19140, USA
2Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA 19140, USA

Received 3 March 2013; Accepted 31 March 2013

Academic Editors: M. Filosto, J. C. Kattah, and F. Micheli

Copyright © 2013 Sisira Yadala and Jin Jun Luo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Marchiafava-Bignami disease (MBD) is a rare neurological disorder mostly seen in alcoholic and malnourished patients with a pathognomonic hallmark of corpus callosum demyelination. MBD in nonalcoholics without malnutrition has rarely been reported. We report a case of MBD in a diabetic patient, without alcoholism or malnutrition, caused by a wide range of glycemic level fluctuations. A 38-year-old man presented with sudden onset of alteration in speech and multiple falls in three days. Neurologic examination showed dysarthria, dysmetria, and ataxia but, otherwise, normal cranial nerves, motor and sensory functions, and tendon reflexes. Brain MRI showed symmetric abnormalities in the splenium of the corpus callosum. In addition, demyelination was also observed in bilateral posterior limbs of the internal capsule and brachium ponti. His symptoms significantly improved after stabilization and normalization of his plasma glucose level and administration of multivitamins and corticosteroids. The underlying pathophysiology of the development of MBD in our case is likely to be osmotic stress from a wide range of glycemic fluctuations causing structural and functional disturbance of oligodendrocytes, which may be reversible in its early stage.