CT shows atrophy of the superior vermis and anterior cerebellar lobes. The disorder is ameliorated with thiamine plus other B vitamins. Marchiafava-Bignami disease is a rare demyelination of the corpus callosum that occurs in chronic alcoholics, predominantly men. Although originally attributed to a crude red wine in Italy, this disorder has occurred in many countries and with many alcoholic beverages. A nutritional etiology has been postulated but remains to be defined.
Patients become agitated and confused, with progressive dementia and frontal release signs.
Pathologic intoxication is a rare syndrome. It is characterized by repetitive, automatic movements and extreme excitement with aggressive, uncontrolled irrational behavior after ingesting a relatively small amount of alcohol. The episode may last for minutes or hours and is followed by prolonged sleep with amnesia for the event on awakening. Differentiating delirium tremens from the mental changes of acute hepatic insufficiency is very important. Delirious patients are extremely suggestible and respond well to reassurance.