Doença de Marchiafava‑Bignami: A Importância do Diagnóstico e Tratamento Precoces por uma Equipa Multidisciplinar
DOI:
https://doi.org/10.51338/rppsm.2020.v6.i1.120Palavras-chave:
Corpo Caloso/diagnóstico por imagem, Doença de Marchiafava‑Bignami/ diagnóstico, Doença de Marchiafava‑Bignami/ tratamento farmacológico, Transtornos Relacionados ao Uso de ÁlcoolResumo
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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