Seok Jung Im, Lee Dong Kuck, Kang Min Gu, Park Jae Han
Department of neurology, School of Medicine, Catholic University of Daegu, Korea.
Behav Neurol. 2007;18(2):131-4. doi: 10.1155/2007/980643.
Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are well recognized syndromes related to the rapid correction of hyponatremia, which are reported to show brain stem signs and various movement disorders. Cognitive dysfunction and neuropsychological findings, however, have seldom been reported. Cognitive manifestations in osmotic myelinolysis may have been underestimated due to the prominent brain stem symptoms and movement disorders. We report a case of EPM without CPM and describe the neuropsychological findings of EPM. The absence of CPM in this case made it possible to test neuropsychological function in the acute stage. Neuropsychological testing showed severe impairment of attention, verbal and visual memory, visuospatial function, and frontal/executive function. Language and language-related functions were normal except naming.
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，据报道会出现脑干体征和各种运动障碍。然而，认知功能障碍和神经心理学表现却鲜有报道。由于突出的脑干症状和运动障碍，渗透性髓鞘溶解症的认知表现可能被低估了。我们报告一例无CPM的EPM病例，并描述EPM的神经心理学表现。该病例中无CPM，使得在急性期能够测试神经心理功能。神经心理学测试显示注意力、言语和视觉记忆、视觉空间功能以及额叶/执行功能严重受损。除命名外，语言及与语言相关的功能正常。
