Kim Jae Ho, Kim Sae Hyun, Jeong Ho Joong, Sim Young Joo, Kim Dong Kyu, Kim Ghi Chan
Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea.
Ann Rehabil Med. 2017 Feb;41(1):148-152. doi: 10.5535/arm.2017.41.1.148. Epub 2017 Feb 28.
Central pontine myelinolysis (CPM) is a demyelinating disorder characterized by the loss of myelin in the center of the basis pons, and is mainly caused by the rapid correction of hyponatremia. We report the case of a young woman who presented with gait disturbance and alcohol withdrawal, and who was eventually diagnosed with CPM. Generally, the cause and pathogenesis of CPM in chronic alcoholics remain unclear. In this cases, the CPM may be unrelated to hyponatremia or its correction. However, it is possible that the osmotic pressure changes due to refeeding syndrome after alcohol withdrawal was the likely cause in this case. This case illustrates the need for avoiding hasty, and possibly incomplete diagnoses, and performing more intensive test procedures to ensure a correct diagnosis.
中央桥脑髓鞘溶解症(CPM)是一种脱髓鞘疾病,其特征是脑桥基底部中央的髓鞘丧失,主要由低钠血症的快速纠正引起。我们报告了一例年轻女性病例,该患者出现步态障碍和酒精戒断症状,最终被诊断为CPM。一般来说,慢性酒精中毒患者CPM的病因和发病机制尚不清楚。在本病例中,CPM可能与低钠血症或其纠正无关。然而,酒精戒断后再喂养综合征导致的渗透压变化可能是本病例的病因。该病例表明需要避免仓促且可能不完整的诊断,并进行更深入的检查程序以确保正确诊断。