摘要
目的分析垂体后叶素致脑桥外髓鞘溶解症(EPM)的临床特点。方法回顾性分析1例应用垂体后叶素致EPM患者的临床资料。结果该患者因支气管扩张咯血予垂体后叶素静脉滴注治疗6 d后出现精神行为异常,当时血钠为109.0 mmol/L;2 d内低钠血症纠正后精神症状加重并相继出现意识障碍及发作性抽搐;查体发现咽反射减弱,四肢肌力、肌张力下降,病理反射阳性;血钠137.6 mmol/L;头颅MRI示双侧尾状核、豆状核、丘脑对称性T1低信号,T2、Flair和DWI高信号改变;经糖皮质激素及对症支持治疗后患者症状有所好转,16个月后生活部分自理。结论垂体后叶素可引起低钠血症继发EPM,过快的纠正低钠血症可加重脑组织的损害。
Objective To analyses the clinical features of extrapontine myelinolysis（EPM） cused by pituitrin.Methods The clinical data of a patient with EPM cused by pituitrin was retrospective analysis.Results The patient was psychiatric and behavior disorder 6 d after pituitrin intravenous drip for treated bronchiectasis and hemptysis.Meanwhile,her blood sodium was 109.0 mmol/L.After the hyponatremia was corrected within 2 d,her psychiatric symptom got more seriously,and disturbance of consciousness and seizures were successively appeared.Examination found that pharyngeal reflex was weakened,extremities muscle force and tension were reduced,and the pathological reflexes was positive.The level of blood sodium was 137.6 mmol/L.MRI was showed that there were symmetrical low signal on T1WI,high signal on T2WI,Flair and DWI in the bilateral caudate nucleus,lenticular nucleus and thalamic region.After the treatment with glucocorticoid and palliatively supporting therapy,the symptoms of the case were improved.Sixteen months later,she can make self-care partly.Conclusions Pituitrin can cause in hyponatremia secondary to EPM.It can aggravate brain damage if redressing hyponatremia too quickly.
出处
《临床神经病学杂志》
CAS
北大核心
2012年第6期458-460,共3页
Journal of Clinical Neurology
