Meyer P, Jouanny P, Laurain M C, Bollaërt P E, Braun M, Mallié J P, Jeandel C
Service de médecine B, hôpitaux de Brabois, CHU de Nancy, France.
Rev Med Interne. 1994 Apr;15(4):282-6. doi: 10.1016/s0248-8663(94)80034-0.
The authors report a case of paucisymptomatic central pontine myelinolysis (CMP). A 66 years old female had severe hypochloronatremia and hypokaliemia due to diuretic. Despite a slow hydroelectrolytic correction, she presented with dumbness and seizure. CT scan showed hypodensity of protuberance and magnetic resonance imaging (MRI) shown hypersignal of protuberance and undercortex, compatible with central and extra pontine myelinolysis. The long term clinical outcome was good, as MRI's data. Rapid and important correction of severe hyponatremia should be the most important factors of demyelination, secondary to interference with cerebral adaptation mechanisms to hypoosmolality. These factors were not present in this case.
作者报告了一例症状轻微的中央脑桥髓鞘溶解症（CMP）。一名66岁女性因使用利尿剂出现严重低氯血症和低钾血症。尽管水电解质缓慢纠正，但她仍出现了失语和癫痫发作。CT扫描显示脑桥突出部低密度，磁共振成像（MRI）显示突出部和皮质下高信号，符合中央和脑桥外髓鞘溶解症。长期临床结果良好，与MRI数据一致。严重低钠血症的快速且显著纠正应是脱髓鞘的最重要因素，这继发于对大脑低渗适应机制的干扰。该病例中不存在这些因素。
