Marchiafava-Bignami Type A Disease: A Rare Neurological Manifestation in Oropharyngeal Cancer

Abstract

Marchiafava-Bignami disease (MBD) is a rare condition characterized by demyelination and necrosis of the corpus callosum, most commonly associated with chronic alcohol consumption. However, it can also occur in non-alcoholic patients and may present secondary to other underlying conditions. We report a case of a 52-year-old male with no history of alcohol use or significant comorbidities, presenting with impaired consciousness and severe malnutrition. Neuroimaging findings confirmed MBD, and further investigation revealed an underlying oropharyngeal malignancy that likely precipitated the disease through feeding difficulties and nutritional deficits. Analytical findings revealed severe metabolic derangements, including hypoalbuminemia and vitamin deficiencies. Despite aggressive treatment, the patient succumbed to his condition. This case highlights the importance of considering MBD in the differential diagnosis of neurological dysfunction in patients with significant malnutrition and emphasizes the need for a thorough investigation into underlying causes, including malignancy.

Keywords: corpus callosum demyelination; esophageal cancer; malnutrition; marchiafava-bignami disease; thiamine deficiency.

Figure 1. Patient MRI and CT findings. Sagittal (A) and axial (B) FLAIR images showing areas of hyperintensity throughout the corpus callosum. (C) Axial head CT images showing corpus callosum hypodensity.