Morlan L, Rodriguez E, Gonzalez J, Jimene-Ortiz C, Escartin P, Liaño H
Department of Neurology, Universidad Autónoma de Madrid, Spain.
Eur Neurol. 1990;30(3):149-52. doi: 10.1159/000117333.
A 37-year-old woman with hepatic failure developed a locked-in syndrome after correction of a severe symptomatic hyponatremia. Magnetic resonance imaging showed a lesion involving the basis pontis and extending into the midbrain, consistent with central pontine myelinolysis. In this patient the rate of correction of hyponatremia was within the range considered sure by several authors, but factors such as hepatic encephalopathy, a single generalized seizure and correction of hyponatremia in 42 h with a change in serum sodium concentration of 34 mmol/l were present, and they could have been etiologically relevant. This case, like other recent reports, suggests new views about the pathogenesis of cerebral demyelinating lesions in patients with hyponatremia.
一名37岁的肝功能衰竭女性在纠正严重症状性低钠血症后出现闭锁综合征。磁共振成像显示病变累及脑桥基底部并延伸至中脑，符合渗透性脱髓鞘综合征。该患者低钠血症的纠正速度在多位作者认为安全的范围内，但存在肝性脑病、单次全身性癫痫发作以及在42小时内纠正低钠血症且血清钠浓度变化34 mmol/L等因素，这些因素可能与病因相关。与其他近期报道一样，该病例提示了关于低钠血症患者脑脱髓鞘病变发病机制的新观点。
