Doença de Marchiafava‑Bignami: A Importância do Diagnóstico e Tratamento Precoces por uma Equipa Multidisciplinar

  • Ana Luzia Melo Psychiatry Resident, Psychiatry and Mental Health Department, Hospital do Espírito Santo de Évora, Évora, Portugal
  • Sara Pires Barata Neuropsychologist, Physical Medicine and Rehabilitation Department, Hospital do Espírito Santo de Évora, Évora, Portugal
  • David Rodrigues Neuroradiology Attendant, Imaging Department, Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
  • Madalena Serra Psychiatry Attendant, Psychiatry and Mental Health Department, Hospital do Espírito Santo de Évora, Évora, Portugal
Palavras-chave: Corpo Caloso/diagnóstico por imagem, Doença de Marchiafava‑Bignami/ diagnóstico, Doença de Marchiafava‑Bignami/ tratamento farmacológico, Transtornos Relacionados ao Uso de Álcool

Resumo

A doença de Marchiafava‑Bignami é uma condição rara associada ao consumo crónico e abusivo de álcool e/ou desnutrição, caracterizada por desmielinização do corpo caloso, sendo geralmente atribuída a uma deficiência de vitaminas do complexo B. Apresentamos o caso de um homem de 34 anos com 10 anos de dependência de álcool que foi trazido ao hospital, após ter sido encontrado caído no chão de sua casa em decúbito ventral, desnutrido, com úlceras de pressão no tórax e joelhos. Estava vígil, não emitia discurso, cumpria ordens simples e apresentava hipertonia espástica generalizada. Na ressonância magnética identificou‑se desmielinização do corpo caloso, sendo diagnosticado com doença de Marchiafava‑Bignami. Foi internado no serviço de psiquiatria e avaliado por uma equipa multidisciplinar, iniciando terapêutica com tiamina e corticosteróides e um programa de reabilitação. Após uma semana, apresentava melhoria clínica e imagiológica. Após um período de 3 meses numa Unidade de Convalescença, teve alta totalmente autónomo.

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Publicado
2020-05-30
Como Citar
Melo, A. L., Barata, S. P., Rodrigues, D., & Serra, M. (2020). Doença de Marchiafava‑Bignami: A Importância do Diagnóstico e Tratamento Precoces por uma Equipa Multidisciplinar. Revista Portuguesa De Psiquiatria E Saúde Mental, 6(1), 31-35. Obtido de https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/120
Secção
Caso Clínico