Department of Neurology, Second Affiliated Hospital of Zhejiang University, School of Medicine, 88 Jiefang Road, Hangzhou 310009, China.
Ann Clin Biochem. 2011 Jan;48(Pt 1):79-82. doi: 10.1258/acb.2010.010152. Epub 2010 Nov 23.
Central pontine myelinolysis (CPM) is a demyelinating disorder, which is associated most commonly with the rapid correction of hyponatraemia and other abrupt changes in physiological osmotic conditions. This includes the treatment of hyperosmolar hyperglycaemia in diabetes mellitus (DM) sufferers. Herein, we report a case of CPM in a 55-y-old patient with new-onset DM who presented with partial focal seizures and a sudden-onset right-sided hemiplegia. Magnetic resonance imaging revealed a lesion in the central pons. The patient responded to glucose control and antiepileptic medication, and achieved a recovery of limb function within 17 d of admission. CPM occurred in this patient before the correction of hyperglycaemic hyperosmolar state, and a disturbance in his initial electrolytes was not found. This report is the first documented case of long-term hyperglycaemic hyperosmolar state leading to CPM, and highlights that CPM can present as an isolated hemiplegia.
桥脑中央髓鞘溶解症（CPM）是一种脱髓鞘疾病，最常与低钠血症的快速纠正以及其他生理渗透压条件的突然变化有关。这包括治疗糖尿病（DM）患者的高渗性高血糖症。在此，我们报告了一例 55 岁新发 DM 患者发生 CPM 的病例，该患者表现为部分局灶性癫痫发作和突发性右侧偏瘫。磁共振成像显示桥脑中央有一处病变。患者对血糖控制和抗癫痫药物治疗有反应，在入院后 17 天内实现了肢体功能的恢复。该患者在纠正高血糖高渗状态之前发生了 CPM，并且在其初始电解质中未发现紊乱。本报告是首例长期高血糖高渗状态导致 CPM 的病例，并强调 CPM 可表现为孤立性偏瘫。
