脑桥中央髓鞘溶解症(附3例报告)

目的探讨脑桥中央髓鞘溶解症（CPM）的病因、临床特点、治疗及其预防措施。方法回顾性分析3例已确诊的CPM患者的诊断资料。结果3例患者均存在严重的基础病症，特别是严重的电解质紊乱（低钠血症），过快纠正后出现球麻痹，四肢瘫痪；头颅磁共振成像（MRI）改变。经激素、脱水剂、B族维生素等治疗，均好转出院。结论营养不良或（和）电解质紊乱是CPM常见的基础疾病，纠正电解质紊乱不宜过快，头颅MRI对本病早期确诊意义较大，早期诊断适当治疗，预后良好。

Central pontine myelinolysis: an analysis of 3 cases

Objective To study the etiology,clinical features,treatment and prevention of central pontine myelinolysis(CPM).Methods Clinical data of 3 cases diagnosed as CPM were retrospectively analyzed.Results All 3 cases of CPM were occurring in patients who had somatic disease and serious systemic functional failure,especially in those who had serious water and ion disturbances,such as hyponatremia.All patients had the pseudobul-baral paralysis and quadriplegia after its too rapid correction.Distribution of lesion were seen on the cranial MRI appeared in all patients,which was the most reliable technique for diagnosing EPM when patients were still alive.All patients recovered well and could lived with treatment by using dehydrating agent,glucocorticoids,B vitamin nutrition of nerve early and so on.Conclusion The occurrence of malnutrition,hyponatremia and its too fast correction may be associated with the onset of CPM.The MRI appearances are strongly suggestive of the diagnosis of CPM.Early diagnosis and proper treatment of CPM may be associated with better recovery.