脑桥外髓鞘溶解症发病机制和治疗策略的探讨(附3例报道)  

Investigation of the Pathogenesis and Management of Extrapontine Myelinolysis:3 Cases Report

作　　者：王敦敬[1] 吕水清 张洪喜[2] 孟闫凯[3] 牟英峰[1] 刘永海[1] 耿德勤[1] 

机构地区：[1]徐州医学院附属医院神经内科,221002 [2]徐州医学院附属医院研究生院,221004 [3]徐州医学院附属医院放射科,221002

出　　处：《中国临床神经科学》2015年第6期652-656,共5页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨脑桥外髓鞘溶解症的发病机制和治疗方法。方法分析3例脑桥外髓鞘溶解症患者的临床特点,包括诱发因素、临床表现、头颅MRI特点、并发症、治疗措施及预后情况等。结果 3例患者均在快速纠正的低钠血症后出现意识障碍,合并有严重肺部感染,头颅MRI示基底节区对称性T1WI低信号,T2WI、Flair、DWI高信号病灶,预后均不佳。结论过快纠正低钠血症和感染是脑桥外髓鞘溶解症的危险因素,降低升高过快的血钠水平能改善病情,有机渗透物是参与发病的重要因素,但其防治作用还有待于临床研究的进一步验证。Aim To investigate the pathogenesis and therapy of extrapontine myelinolysis. Methods The clinical features of 3 patients with extrapontine myelinolysis were analyzed, including the inducing factors, clinical manifestations, cranial MRI, complications, treatment and prognosis. Results All the three patients manifested disturbance of consciousness after rapid correcting of hyponatraemia, complicated with lung infection, had T1WI hypointensity and T2WI,T2 FLAIR,DWI hyperintensity of symmetrical bilateral basal ganglia on brain MRI, and had bad prognosis. Conclusion Extrapontine myelinolysis is associated with the rapid correcting hyponatraemia, which can be improved by lowering the rapidly rising serum sodium concentration, and the organic osmolytes may be its beneficial management.

关 键 词：脑桥外髓鞘溶解症 发病机制 治疗 

分 类 号：R744.5[医药卫生—神经病学与精神病学]