Neurotoxicology

A61-year-old male.who drank about 0.7 I ofjapanese spirits (schnapps) and whisky daily for a long time, was adomined urgently because of consciousness disturbance. He was mute and anorectic for several days prior to his admission. Af’ter 5 days the trouble of consciousness exacerbated; he made no response to stimuli with pyramidal sign and opisthotonic posturc.Aftenuards he became gradually lucid and neurological symptoms improved. He was left dementia (IQ5l)accompanied with ideomotor apraxia and disorder of tactile naming on the left hand. MRI revealed lesions of the central portions of the corpus callosum as well as the deep white matter of the left frontal lobe. Liver function was mildly damaged(semmy-GTP 193,cholinesterase 0.28). He suddenly died of suffocation at the age of 63. At autopsy liver fibrosis was noted.Tne surface of brain (weigt: 121Og) was covered with thin clonic subdural hematoma. Bilateral frontal lobes appeared atmphic. On section the corpus callosum was thin necrcsis at genu and splenium. In the deep WhitC.matter near the left anterior horn of lateral ventricle, there was a cystic cavitation. Histologically. the corpus callosum was diffusely demyelinated with relative preservation of axons. the cavitating lesion in the left frontal lobe was sharply demarcated with reactive ashocytosis. There was diffuse pallor of myelin staining in white maner of occipital lobe. No remarkable microscopical feature of alcoholic intoxication was found in other parts of brain. Is it possible to consider this case as MarchiafavaBignami disease? P5.M.02 Selective neurodegeneration in chronic alcoholics and changes in regional brain volumes G. Halliday, J. Kril and A. Harding, Prince of Wales Medical Research Institute, Randwick, 2031 and Department of Pathology, University of Sydney, 2006, Australia.