Department of Neurology, Goa Medical College, Bambolim, Goa 403 202, India.
J Clin Neurosci. 2012 Aug;19(8):1165-7. doi: 10.1016/j.jocn.2011.11.024. Epub 2012 Jun 7.
Extrapontine myelinolysis (EPM) is rare and usually results from osmotic stress due to inappropriate correction of electrolyte disturbances. Parkinsonism is a relatively common manifestation of EPM, seen in 60% of patients. Dopaminergic therapy leads to good recovery in many patients. Delayed extrapyramidal manifestations, including hyperkinetic movement disorders such as chorea or dystonia, are postulated to result from aberrant neuronal regeneration or denervation supersensitivity following the initial osmotic insult. We present a patient with a symmetric parkinsonian syndrome due to EPM involving the striatum who made a good recovery with levodopa therapy, only to develop chorea five months later. The possible mechanisms underlying the genesis of these movement disorders in EPM is discussed.
桥外髓鞘溶解症（EPM）较为罕见，通常是由于电解质紊乱纠正不当导致的渗透压改变所致。帕金森病是 EPM 较为常见的表现之一，见于 60%的患者。多巴胺能治疗可使许多患者得到良好恢复。推测继发于最初渗透压损伤后的异常神经元再生或去神经超敏导致出现迟发性锥体外系表现，包括舞蹈病或肌张力障碍等多动性运动障碍。我们报告了 1 例 EPM 累及纹状体导致的对称帕金森综合征患者，经左旋多巴治疗后恢复良好，但 5 个月后出现舞蹈病。讨论了 EPM 中这些运动障碍发生的可能机制。
