Paucisymptomatic Marchiafava–Bignami disease with relevant diffusion-weighted MRI lesions

Marchiafava–Bignami disease (MBD) is a rare alcohol-associated disorder characterized by demyelization andnecrosis of the corpus callosum. Diffusion-weighted (DW) MRI may reveal the lesions in patients showing seriousclinical manifestations, high mortality rate and severe cognitive squeals, though some cases with good outcomehave been reported. We describe a case of a man with a history of chronic alcohol abuse associated withmalabsorption; the man presented mild clinical signs on the first neurological exam, despite the presence ofDW-MRI lesions, bilaterally involving entire corpus callosum that are compatible with MBD diagnosis.