Laubenberger J, Schneider B, Ansorge O, Götz F, Häussinger D, Volk B, Langer M
Department of Diagnostic Radiology, University of Freiburg, Germany.
Eur Radiol. 1996;6(2):177-83. doi: 10.1007/BF00181139.
Central pontine myelinolysis (CPM) is a neurologic disorder once thought to be uniformly fatal. With the introduction of CT and MRI there was an increasing number of reports on nonfatal cases of CPM. Nearly all reports on nonfatal cases describe severe clinical syndromes with tetraparesis, bulbar palsy, and coma. We reviewed nine patients with CPM and compared the size of the pontine lesion on MRI and CT with the severity of clinical presentation. Clinical presentation of CPM was highly variable: The symptoms ranged from severe neurologic disorders to mild neurologic disturbances only. Two of nine patients died from CPM. The size of the pontine lesion did not correlate with the severity of the neurologic illness or the final outcome. Mild forms of CPM might be difficult to diagnose clinically. This applies even more for patients with underlying diseases such as Wernicke's encephalopathy, which in itself might cause a clinical picture similar to that of CPM. Central Pontine Myelinolysis is a major differential diagnosis in acute neurologic deterioration indicating pontine damage. Magnetic resonance imaging is the decisive diagnostic tool for CPM.
中央桥脑髓鞘溶解症（CPM）是一种曾被认为必然致命的神经系统疾病。随着CT和MRI的问世，关于CPM非致命病例的报道越来越多。几乎所有关于非致命病例的报道都描述了伴有四肢轻瘫、延髓麻痹和昏迷的严重临床综合征。我们回顾了9例CPM患者，并将MRI和CT上桥脑病变的大小与临床表现的严重程度进行了比较。CPM的临床表现差异很大：症状从严重的神经系统疾病到仅为轻度的神经功能障碍不等。9例患者中有2例死于CPM。桥脑病变的大小与神经疾病的严重程度或最终结局无关。CPM的轻症形式可能在临床上难以诊断。对于患有潜在疾病如韦尼克脑病的患者更是如此，因为韦尼克脑病本身可能会导致与CPM相似的临床表现。中央桥脑髓鞘溶解症是提示桥脑损伤的急性神经功能恶化的主要鉴别诊断。磁共振成像（MRI）是CPM的决定性诊断工具。
