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Introduction: Both Machiafava-Bigmami disease (MBD) and Wernicke’s encephalopathy (WE) result from hypovitaminosis mainly associated with chronic alcoholism. The former affects the corpus callosum while the latter affects mostly the mammillary bodies. There are two main clinical subtypes for MBD in Heinrich’s classification. In type A the entire corpus callosum is affected and is characterized by acute or subacute lowering of consciousness and pyramidal deficits. A poor outcome is expected even with initial, prompt therapy. Methods: Case study with medical record review. Case report: Female patient, 53 years old, with subacute monoparesis in the right lower limb, progressing to generalized paresis, altered mental status and communication impairment. She reported smoking and chronic alcohol addiction for 30 years. She was emaciated, dehydrated, drowsy, sometimes agitated; she had eye opening to speech, dysarthric, bradypsychic, hypoactive pupils, bilateral evoked horizontal nystagmus, proximal paresis with dystonic posture. Impaired coordination and gait, with no other positive findings. Head-CT showed hypodensity in the corpus callosum, more pronounced in the splenium. Head- MRI indicated signs of abnormal impregnation in the mammillary bodies, cerebellar atrophy in the anterior vermis, diffuse cytotoxic lesion in the corpus callosum compatible with toxic demyelination. Conclusion: Although rare, such conditions must be recognized and treated promptly in order to delay progress and improve prognosis.