vitamin-b-12 and Marchiafava-Bignami-Disease

Apraxic agraphia can be caused by left hemispheric cerebral lesions in the area that contains the spatial representations of the movements required to write, from a lesion in, or connections to, the frontal premotor cortex that converts these spatial representations to motor programs (Exner's area).  A right-handed woman with Marchiafava Bignami disease and lesions of the genu and splenium of her corpus callosum had apraxic agraphia without ideomotor apraxia of her left. A disconnection of Exner's area in the left hemisphere from the right hemisphere's premotor and motor areas may have led to her inability to write with her left hand.

Topics: Adult; Agraphia; Apraxias; Corpus Callosum; Female; Folic Acid; Functional Laterality; Homocysteine; Humans; Magnetic Resonance Imaging; Marchiafava-Bignami Disease; Vitamin B 12

Marchiafava-Bignami disease (MBD) is characterized by demyelination and necrosis of corpus callosum encountered in chronic alcoholic patients. Etiology is the deficiency of vitamin B complex. Magnetic resonance imaging (MRI) in MBD typically reveals focal lesions of high T2 and FLAIR signal intensity in the corpus callosum. We here present a 42-year-old male alcoholic diagnosed as MBD on the basis of MRI and diffusion-weighted imaging (DWI) features. The patient totally recovered following appropriate vitamin B complex replacement therapy, despite reduced diffusion in the initial setting. This case report emphasizes on the important role played by MRI and DWI in the early diagnosis and follow-up of this potentially fatal disease.

Topics: Adult; Diffusion Magnetic Resonance Imaging; Humans; Male; Marchiafava-Bignami Disease; Pyridoxine; Thiamine; Vitamin B 12