Reversible splenial lesion syndrome (RESLES) is frequently observed in encephalitis or encephalopathy caused by various pathogens such as influenza virus A, rotavirus, and measles. It is also associated with epileptic seizures, anti-epileptic drug withdrawal and neuroleptic malignant syndrome. We report here a Sri Lankan woman with RESLES associated with anti-NMDAR antibody encephalitis and neuroleptic malignant syndrome.

Marchiafava–Bignami disease (MFBD) was first described by Italian pathologists Amico Bignami and Ettore Marchiafava in 1903 in an Italian Chianti wine drinker. Clinical presentation is variable, and include impaired consciousness, disorientation, aggression, seizures, depression, hemiparesis, ataxia, apraxia, psychosis, personality changes and coma.1 Magnetic Resonance Imaging (MRI) is the most sensitive diagnostic tool for MFBD and reveals corpus callosal demyelination, necrosis and subsequent atrophy. No specific treatment is available but thiamine, folate, and other B vitamins (especially vitamin B12) are commonly used with some success. We report here a man with possible MFBD with features of interhemispheric disconnection on serial MRIs. Written informed consent was obtained from the patient’s legal guardian for publication of this report.