Neuroimaging Findings in Alcohol-Related Encephalopathies

Neuroimaging features in subacute encephalopathy with seizures in alcoholics (SESA syndrome)

“…Alcohol abuse is associated with various entities that cause abnormalities apparent on imaging, such as Wernicke encephalopathy, Marchiafava-Bignami disease, osmotic demyelination syndromes, hepatic encephalopathy, alcohol withdrawal syndrome [11], or SESA syndrome. All of these conditions usually present with confusion.…”

“…Osmotic demyelination syndrome is known for central pontine changes (although symmetric signal changes can be seen in other brain areas) [14]. MRI during alcohol withdrawal depicts cytotoxic edema during the acute and subacute phases and significant volume loss in the temporal regions [11]. …”

Marchiafava-Bignami disease as a cause of visual hallucinations

“…2 There are distinct differences in alcohol use between religious traditions, as we reported in a recent article. 3 For instance, Afro-Brazilian religions (i.e., Umbanda) utilize alcohol in their rituals, whereas some Brazilian Protestant Evangelicals forbid its use entirely, whether for religious or non-religious purposes. With regard to the concepts of spirituality and religiosity and their measurement, we agree that these are distinct constructs, sometimes difficult to distinguish.…”

“…MBD is characterized by progressive demyelination and thinning of the corpus callosum, affecting mainly the genu and the splenium, that can even progress to focal necrosis. 3 In acute MBD, patients may present with seizures or coma, whereas patients with chronic MBD usually exhibit cognitive deficits, hallucinations, or depression lasting for several months. MBD can also coexist with Wernicke's encephalopathy, Korsakoff's syndrome, osmotic demyelination syndrome, and Morel's laminar necrosis, which are also associated with chronic alcoholism.…”

“…In the acute phase, there can be peripheral enhancement on postcontrast studies, and lesions exhibit restricted diffusion. 3 Heinrich et al 4 proposed an imaging-based classification in which the type A corresponds to diffuse callosal involvement, whereas type B, which carries a better prognosis, includes only partial lesions.…”