Marchiafava-Bignami Disease (MBD) in a Non-Alcoholic Patient: A Case Report
Bibliographic record
Abstract
Marchiafava-Bignami disease (MBD) is a rare disease characterized by primary focal demyelination of the corpus callosum, although lesions involving the cerebellar peduncles and the cerebral hemispheres have also been reported. 1archiafava and Bignami, in 1903, first described the disease in three Italian patents with a history of red wine consumption. 2The patients typically present with neuropsychiatric complaints, dysarthria, tetraparesis, astasia-abasia, impaired consciousness and symptoms of inter hemispheric disconnection.Owing to a lack of specific clinical features, the modern diagnosis is almost always based entirely on the magnetic resonance image (MRI) findings. 3archiafava-Bignami disease has traditionally been described as a consequence of chronic alcohol abuse.However, the occurrence of the disease in non-alcoholics suggests that the precise etiology remains to be established. [4][5]5] Here, we describe an unusual presentation of MBD in a non-alcoholic. CASE REPORTA 45-year-old, left-handed, Caucasian, non-alcoholic industrial worker presented with a history of lapses in memory for over a year.His family also noticed changes in his behavior, although he remained oblivious to it.He had become much quieter and socially withdrawn.He had no weakness, numbness or tingling.There was no history of urinary incontinence or gait disturbance.He had an occupational exposure to acetone and methyl ethyl ketone over a period of 14 years.On neurological examination, the deep tendon reflexes were diminished bilaterally.Frontal release signs (glabellar and snout) were positive.The rest of the general neurologic examination was normal.A neuropsychiatric evaluation revealed marked impairment in immediate recall and episodic memory, language and attention.There were mild deficits on visuospatial and semantic testing.The basic metabolic panel and vasculitic workup were within normal limits.The MRI brain showed focal demyelination involving the genu and splenium of the corpus callosum (Figures 1,2).There was diffusion restriction in the corpus callosum and a corresponding subtle change on the apparent diffusion coefficient map.A lumbar puncture showed a normal glucose, proteins and cell count.The IgG synthesis and oligoclonal bands were within the normal range.A paraneo-plastic panel was unrevealing.The constellation of clinical symptoms, the radiological findings, and the lack of an alternate diagnosis suggested a diagnosis of probable MBD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".