Mascarenhas J V, Jude E B
Department of Diabetes and Endocrinology, Tameside NHS Foundation Trust, Manchester, UK.
BMJ Case Rep. 2014 Mar 28;2014:bcr2013203516. doi: 10.1136/bcr-2013-203516.
Central pontine myelinolysis (CPM), which is a component of the osmotic demyelination syndrome (ODS), is a frequent neurological complication that follows rapid correction of hyponatraemia. However, there are other predisposing risk factors (chronic alcoholism, hypokalaemia) that perpetuate the development of ODS. We report a case of a 39-year-old woman with a history of chronic alcoholism who presented to us with progressive neurological deficits (paraparesis, paresthesias). She was initially detected to have coexisting hypokalaemia which was eventually rectified with potassium supplementation. However, she continued to experience progressive worsening of her neurological symptoms despite adequate potassium supplementation. Therefore, a neurological opinion was sought for and she was diagnosed with CPM based on a background of chronic alcoholism and malnutrition; an MRI of the brain showed a hyperintense signal in the central pontine region. Following the diagnosis of CPM, she was rehabilitated with occupational and physiotherapy.
中央脑桥髓鞘溶解症（CPM）是渗透性脱髓鞘综合征（ODS）的一个组成部分，是快速纠正低钠血症后常见的神经系统并发症。然而，还有其他诱发危险因素（慢性酒精中毒、低钾血症）会促使ODS的发展。我们报告一例有慢性酒精中毒病史的39岁女性，她出现进行性神经功能缺损（双下肢轻瘫、感觉异常）前来就诊。最初检测发现她同时存在低钾血症，最终通过补充钾得到纠正。然而，尽管补充了足够的钾，她的神经症状仍持续进行性加重。因此，寻求了神经科会诊意见，基于慢性酒精中毒和营养不良的背景，她被诊断为CPM；脑部MRI显示脑桥中央区域有高信号。诊断为CPM后，她接受了职业治疗和物理治疗进行康复。
