Central Pontine and Extrapontine Myelinolysis that Developed during Alcohol Withdrawal, without Hyponatremia, in a Chronic Alcoholic
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概要
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Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are osmotic demyelination syndrome. A 45-year-old man with a history of alcoholism visited the ER with dysarthria and dysphagia for 2 days. These symptoms occurred 3 days after he had stopped drinking alcohol. The neurological symptoms progressed to anarthria, pseudobulbar palsy and gait disturbance. During admission, the electrolyte studies were within the normal range. Diffusion-weighted images revealed high signal intensities in the pons, thalamus and basal ganglia. Apparent diffusion coefficient image showed low signal intensities in the pontine lesion, but isosignal intensities in the extrapontine lesion. The symptoms gradually improved after 1 month with only conservative treatment. The 1 month-follow-up MRI showed significant reduction of the previous extrapontine lesions. These findings suggest that cytotoxic edema is central to the pathogenesis of CPM, but vasogenic edema plays an important role in the pathogenesis of EPM occuring during alcohol withdrawal.
- 社団法人 日本内科学会の論文
著者
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Park Sung
Department Of Anesthesia And Pain Medicine School Of Medicine Pusan National University
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An Jae
Department Of Materials Science And Engineering Inha University
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Song In
Department of Advanced Material Engineering, Daejeon University, Daejeon 300-716, Republic of Korea
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An Jae
Department of Neurology, College of Medicine, The Catholic University of Korea
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Han Si
Department of Neurology, College of Medicine, The Catholic University of Korea
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Park Sung
Department of Neurology, College of Medicine, The Catholic University of Korea
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