Objective: To discuss the
etiology, diagnosis and treatment of central pontine myelinolysis (CPM) by
analyzing 4 cases of our center and 26 cases reported by others in our country.
Methods: We analyzed the clinical feature, diagnosis and treatment of 4 CPM
cases and then compared them with 26 CPM cases reported between 2000 and 2010. Results:
The average age of our 4 cases (3 men and 1 woman) was 47.5 years old. All
cases were diagnosed by MRI scan. The patients all had been diagnosed as liver cirrhosis
and most of the CPM related symptoms were observed within 2 weeks after surgery,
including neural and psychic symptoms and physical impairment. Rapid correction
of hyponatremia during perioperative period and high blood concentration of
FK506 may be the main causes. All cases received etiological and symptomatic
combination treatment and were continued with neural function training after
hospital discharge. A long-term follow-up (29.5 ± 15.0 months) showed an improvement
of neural function to different degrees. Conclusion: CPM after liver
transplantation is a severe complication, of which the etiology and
pathogenesis were not clear. MRI scan is the main method for confirmative
diagnosis. Etiological prevention and timely treatment may improve the
prognosis.
Cite this paper
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