Seok Jung Im, Youn Jinyoung, Chung Eun Joo, Lee Won Yong
Movement Disorder Division, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Parkinsonism Relat Disord. 2006 Oct;12(7):462-4. doi: 10.1016/j.parkreldis.2006.02.002. Epub 2006 May 30.
Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are well recognized syndromes related to rapid correction of hyponatremia and have been reported to show a variety of movement disorders. However, sequential observation of movement disorders as well as brain images has seldom been reported. We report a case of CPM and EPM presenting with various sequential changes in movement disorders including delayed choreic movement over 11 months; we present sequential brain magnetic resonance images showing increased T1 and decreased fat-suppression T1 signal intensity. We suggest that delayed low signal intensity, in the fat-suppression T1-weighted images, is a result of the destruction of myelin and by products. Damage to the myelin may cause various movement disorders in a delayed manner.
中央桥脑髓鞘溶解症（CPM）和脑桥外髓鞘溶解症（EPM）是与低钠血症快速纠正相关的公认综合征，据报道可出现多种运动障碍。然而，很少有关于运动障碍以及脑部影像的连续观察报道。我们报告一例CPM和EPM患者，其运动障碍呈现出各种连续变化，包括长达11个月的迟发性舞蹈样动作；我们展示了连续的脑磁共振图像，显示T1信号增强以及脂肪抑制T1信号强度降低。我们认为，脂肪抑制T1加权图像中的延迟低信号强度是髓鞘和副产品破坏的结果。髓鞘损伤可能会延迟导致各种运动障碍。
