脑桥外髓鞘溶解症8例临床分析

Clinical analysis of 8 cases of extrapontine myelinolysis

目的:探讨脑桥外髓鞘溶解症的临床、影像表现及预后。方法:回顾性分析8例脑桥外髓鞘溶解症患者的临床、影像表现及预后。结果:8例均有快速纠正血钠病史。临床表现:昏迷4例,锥体外系症状3例,精神症状1例,癫痫1例。MRI影像表现:8例均出现双侧基底节对称性信号,5例出现对称弥漫性脑皮层肿胀,其中4例有脑回样的强化,有4例早期MRI正常,1周后复查出现异常表现;临床预后:3个月随访MRS评分0分1例,1分2例,2分4例,6分1例。结论:脑桥外髓鞘溶解症临床表现多样,影像类似缺血缺氧性脑病,但预后较缺血缺氧性脑病好。

Objective:To explore the clinical and imaging manifestations and prognosis of extrapontine myelinolysis.Methods:Theclinical and imaging manifestations and prognosis of 8 patients with extrapontine myelinolysis were retrospectively analyzed.Results:8 patients had a rapid correction of blood sodium medical history.The Clinical manifestation were 4 cases of coma,3 casesof extrapyramidal symptom,1 case of mental symptom,1 case of epilepsy.The MR imaging manifestations were that 8 casesappeared bilateral basal ganglia symmetry signal,5 cases appeared symmetric diffuse cerebral cortex swelling,including 4 cases ofenhanced gyriform enhancement,4 cases of early MR normal appeared abnormal performance after 1 week review.The clinicalprognosis :3 months follow-up MRS score,1 case of 0 point,2 cases of 1 point,4 cases of 2 points,1 case of 6 points.Conclusion:Theextrapontine myelinolysis has diverse clinical manifestations,its image similar hypoxic ischemic encephalopathy,but its prognosisis better than hypoxic ischemic encephalopathy(HIE).