脑桥中央和脑桥外髓鞘溶解症的临床分析和影像特点

目的:探讨脑桥中央和脑桥外髓鞘溶解症的临床及神经影像特点。方法:分析3例脑桥中央髓鞘溶解症和1例脑桥外髓鞘溶解症患者的临床特点,包括起病前诱因、临床表现、头颅MRI特点、治疗及预后情况。结果:4例患者均有慢性形成低钠血症后被快速纠正的病史,以意识改变、构音和吞咽困难、四肢瘫痪等为临床表现。3例脑桥中央髓鞘溶解症的MRI表现为脑桥部位对称性的T1加权低信号灶、T2加权高信号灶,呈环状分布;1例脑桥外髓鞘溶解症者在基底节区域有对称性的T1加权低信号、T2加权高信号病灶。4例患者总体预后良好。结论:提高髓鞘溶解症的认识对于本病的防治非常重要,缓慢纠正慢性形成的低钠血症是预防的关键。

Clinical Analysis and Neuroimaging Features of Central Pontine and Extrapontine Myelinolysis

Aim:To investigate the clinical features and neuroimaging features of myelinolysis in central pontine and extrapontine.Methods:The clinical features of 3 patients with central pontine myelinolysis and 1 case with extrapontine myelinolysis were analyzed,including the inducing factors,clinical manifestations,cranial MRI,treatment and prognosis.Results:All the four patients had the history of rapidity of correcting chronic hyponatraemia.The common clinical manifestations included change of consciousness,dysphasia,dysphagia,tetraplegia,etc.By means of MRI scan,3 patients were confirmed as central pontine myelinolysis and one case as extrapontine myelinolysis.Conclusion:The increase in knowledge about myelinolysis in central pontine and extrapontine is essential for the prophylaxis and treatment of this rare disorder,and avoiding the rapidity of correcting chronic hyponatraemia is the key point for preventing its happening.