无低钠血症的酒依赖综合征患者的突出中央髓鞘溶解症
Striking Central Pontine Myelinolysis in a Patient With Alcohol Dependence Syndrome Without Hyponatremia Patricia H.McNamara,MRCPUK, PhD1; JenniferWilliams,MRCPI1; Dominick J. H.McCabe,PhD, FRCPI2,3;
Striking Central Pontine Myelinolysis in a Patient With Alcohol Dependence Syndrome Without Hyponatremia
Patricia H. McNamara, MRCPUK, PhD1; Jennifer Williams, MRCPI1; Dominick J. H. McCabe, PhD, FRCPI2,3; Richard A. Walsh, MD, MRCPI1
A man in his 70s with known alcohol dependence syndrome was admitted to our institution after he was found collapsed at home. He reportedly consumed more than 1 bottle of liquor daily for several years. On general examination, he was unkempt and had a low body mass index consistent with his poor nutritional status. Neurological examination revealed gaze-evoked nystagmus in all directions, severe dysarthria, limb and truncal ataxia, and extensor plantars.
Neuroimaging revealed a striking triangular central pontine defect in keeping with central pontine myelinolysis (CPM) (Figure). The patient had normal sodium and glucose levels throughout his admission and for the previous 12-month period. Treatment with high-dose intravenous thiamine only led to a partial clinical improvement. He remained significantly disabled, unable to weight-bear, and required assistance with all activities of daily living by the time of his discharge.
JAMA Neurol. 2016;73(2):234-235. doi:10.1001/jamaneurol.2015.2201.
相关文章
评论
我要跟帖
