桥脑及桥脑外髓鞘溶解症4例分析

Analysis of 4 cases with central pontine myelinolysis and extral pontine myelinolysis

目的探讨桥脑中央髓鞘溶解症(CPM)的病因、诊断和康复治疗。方法回顾性分析4例CPM的临床资料。结果4例均表现为假性延髓麻痹、肌张力增高;3例有意识不清;2例发生在低钠血症被快速纠正之后;1例发生在高钠血症被快速纠正之后。4例均经头颅MRI检查显示桥脑脱髓鞘病灶,其中3例同时显示脑干外病灶。4例预后均良好。结论低钠血症被快速纠正是CPM的常见原因,综合康复治疗可以改善预后,提高生活质量。

Objective To explore the pathogeny, diagnosis and rehabihtatlon ot central pontme myelmolysm, Methods Ckinical data of four patients with central potine myelinolysis were studied retrospectively. Results All of them had pseudobulbar palsy and dystonia; three had coma; two had history of hyposodemia ameliorated rapidly, one had history of hypersodemia ameliorated rapidly. All of them had focuses in pons; three had focuses beyond pons. All patients had good prognoses. Conclusion History of hyposodemia ameliorated rapidly is a usual pathogeny of central potine myelinolysis, integrative measures of rehabilitation can improve prognosis and quality of daily life.