Lee Kyoung Bo, Hong Bo Young, Kim Joon Sung, Son Dong Back, Choi Sang Il, Lim Seong Hoon
Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea: 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea.
J Phys Ther Sci. 2019 Aug;31(8):698-701. doi: 10.1589/jpts.31.698. Epub 2019 Aug 9.
[Purpose] Central pontine demyelination is a common osmotic demyelination syndrome. Typically, central pontine demyelination shows high signal intensity with demyelination in the mid-pons. Despite severe imaging findings, patients usually recover. This study investigated the integrity of the corticospinal tract (CST) and corticoreticular pathway (CRP) in patients at 12 months after the onset of central pontine demyelination. [Participants and Methods] This retrospective cross-sectional observational study assessed two patients with central pontine demyelination, who were ultimately able to walk without using an aid or orthosis and to use both hands but with mild residual symptoms. All participants underwent diffusion tensor imaging (DTI) at 12 months after onset. [Results] Both patients had mild ataxia at 12 months after onset. The integrity of the CST was restored in both cases, while the integrity of the CRP recovered partially. [Conclusion] The integrity of the CST and CRP at 12 months after the onset of central pontine demyelination was similar in both cases as well as the recovery status of the hand function and ambulation. These results may be useful in planning therapy for patients with central pontine demyelination.
[目的] 脑桥中央髓鞘溶解症是一种常见的渗透性脱髓鞘综合征。通常,脑桥中央髓鞘溶解症在脑桥中部表现为脱髓鞘的高信号强度。尽管影像学表现严重,但患者通常会康复。本研究调查了脑桥中央髓鞘溶解症发病12个月后患者皮质脊髓束(CST)和皮质网状通路(CRP)的完整性。[参与者与方法] 这项回顾性横断面观察性研究评估了两名脑桥中央髓鞘溶解症患者,他们最终能够无需辅助器具或矫形器行走,且双手功能尚可,但仍有轻度残留症状。所有参与者在发病12个月后接受了扩散张量成像(DTI)检查。[结果] 两名患者在发病12个月后均有轻度共济失调。两例患者的CST完整性均得以恢复,而CRP的完整性部分恢复。[结论] 两例脑桥中央髓鞘溶解症患者在发病12个月时CST和CRP的完整性以及手部功能和行走能力的恢复状况相似。这些结果可能有助于为脑桥中央髓鞘溶解症患者制定治疗方案。