神经病学与神经康复学杂志2025，Vol.21Issue(2)：123-130,8.DOI:10.12022/jnnr.2024-0231
新型冠状病毒感染后渗透性脱髓鞘综合征:4例报告及文献复习
Osmotic demyelination syndrome after COVID-19 infection:a report of 4 cases and literature review
王谟兰 1陈林云 2苏娅 3韩翔 3张书凡 3杨仕林3
作者信息
- 1. 江苏省扬州五台山医院神经内科,江苏 扬州 225003
- 2. 沧州市人民医院神经内科,河北 沧州 061000
- 3. 复旦大学附属华山医院神经内科,上海 200040||复旦大学脑功能与脑疾病全国重点实验室,上海 200040
- 折叠
摘要
Abstract
Object:To improve the understanding of osmotic demyelination syndrome(ODS)after coronavirus disease 2019(COVID-19)infection.
Method:The clinical manifestations and imaging features of 4 patients with ODS after COVID-19 infection were retrospectively described,and the related literatures were reviewed and analyzed.
Results:All 4 patients suffered from severe hyponatremia and overcorrection after COVID-19 infection,with clinical manifestations including fever,vomiting,disturbance of consciousness,convulsions and movement disorders.No abnormalities were found in head MRI examination the early stage of the disease,and extrapontine lesions with or without pontine involvement appeared after 2-3 weeks.The patients were treated with gammaglobulin,steroids and plasmapheresis.Two patients achieved favorable outcomes,while the other two had poor prognoses.
Conclusion:Patients with COVID-19 infection are at high risk of ODS,which may be related to overly rapid sodium supplementation within 24 hours in the context of pre-existing hyponatremia.Other contributing factors include hypertension and hypovolemia induced by diuretic use.Close monitoring of serum sodium levels is essential during sodium supplementation.If the patient exhibits symptoms such as altered consciousness or head MRI suggests lesions involving the cortex,more aggressive immunotherapy and appropriate nursing measures should be taken.关键词
新型冠状病毒感染/低钠血症/渗透性脱髓鞘综合征/脑桥外髓鞘溶解/脑桥中央髓鞘溶解Key words
COVID-19 infection/Hyponatremia/Osmotic demyelinating syndrome/Extrapontine myelinolysis/Central pontine myelinolysis引用本文复制引用
王谟兰,陈林云,苏娅,韩翔,张书凡,杨仕林..新型冠状病毒感染后渗透性脱髓鞘综合征:4例报告及文献复习[J].神经病学与神经康复学杂志,2025,21(2):123-130,8.
