Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Central Pontine Myelinolysis: A Hitherto Undescribed Disease Occurring in Alcoholic and Malnourished Patients

Central Pontine Myelinolysis: A Hitherto Undescribed Disease Occurring in Alcoholic and... Abstract In the course of our studies of the neuropathology of alcoholism, which were begun at the Neurological Unit, Boston City Hospital, and have continued in the laboratories of the Neurology Service, Massachusetts General Hospital, two of us (R. D. A. and M. V.) observed three, perhaps four, cases in which the myelin sheaths of all the nerve fibers in the central part of the basis pontis had been destroyed in a single, large, symmetric focus. The nerve cells and axis cylinders were spared for the most part, and the blood vessels were patent and unaffected. There were no signs of inflammation in or near the lesion. The disease had occurred on a background of alcoholism and malnutrition; in the two cases with the largest lesions, it had manifested itself clinically by a pseudobulbar palsy and quadriplegia, leading to death in about 13 and 26 days. In the other two cases References 1. Foix, C., and Hillemand, P.: Contribution à l'étude des ramollissements protubérantiels , Rev. méd., Paris 43:287-305, 1926. 2. Kubik, C. S., and Adams, R. D.: Occlusion of the Basilar Artery—A Clinical and Pathological Study , Brain 69:73-121, 1946.Crossref 3. Adams, R. D., and Kubik, C. S.: Symposium on Multiple Sclerosis and Demyelinating Diseases: The Morbid Anatomy of the Demyelinative Diseases , Am. J. Med. 12:510-546, 1952.Crossref 4. Victor, M., and Adams, R. D.: Unpublished data. 5. Testa, U.: Lesioni del corpo calloso nell'alcoolismo subacuto sperimentale , Riv. sper. freniat. 52:559-574, 1928-1929. 6. Victor, M., and Adams, R. D.: Unpublished data. 7. King, L. S., and Meehan, M. C.: Primary Degeneration of the Corpus Callosum (Marchiafava's Disease) , Arch. Neurol. & Psychiat. 36: 547-568, 1936. 8. Gruner, J. E.: Sur la pathologie des encéphalopathies alcooliques , Rev. neurol. 94:682-689, 1956. 9. Girard, P. F.; Garde, A., and Devic, M.: Considérations terminologiques, étiologiques, anatomiques et cliniques concernant l'encéphalopathie de Gayet-Wernicke, ses rapports avec le syndrome de Marchiafava-Bignami et la psychose de Korsakow , Rev. neurol. 88:236-248, 1953. 10. Garde, A.; Girard, P. F., and Pallasse, A.: L'Encéphalopathie hémorragique de Gayet-Wernicke et la dégénérescence subaiguë du corps calleux de Marchiafava-Bignami: A propos d'une observation anatomo-clinique , Rev. Lyon. méd. 1:99-108, 1952. 11. Schwob, R. A.; Gruner, J.; Foucquier, E.; Harl, J. M.; Françon, J., and Guerre, J.: Sur trois cas de syndrome confusionnel avec contracture chez des éthyliques: Le Problème des encéphalopathies carentielles , Rev. Neurol. 88:174-190, 1953. 12. Estrada, R., and Fuste, F.: Encefalopatía alcohólica: estudio de un caso en que se combinan los caracteres patológicos de la enfermedad de Marchiafava y los de la polioencefalitis de Wernicke , Arch. hosp. Univ., Habana 4:371-390, 1952. 13. Delay, J.; Boudin, G.; Brion, S., and Barbizet, J.: Étude anatomo-clinique de huit encéphalopathies alcooliques: encéphalopathie de Gayet-Wernicke et syndromes voisins , Rev. neurol. 94:596-601, 1956, Case 7. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

Central Pontine Myelinolysis: A Hitherto Undescribed Disease Occurring in Alcoholic and Malnourished Patients

Loading next page...
 
/lp/american-medical-association/central-pontine-myelinolysis-a-hitherto-undescribed-disease-occurring-0t10OL2K2x
Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1959.02340140020004
Publisher site
See Article on Publisher Site

Abstract

Abstract In the course of our studies of the neuropathology of alcoholism, which were begun at the Neurological Unit, Boston City Hospital, and have continued in the laboratories of the Neurology Service, Massachusetts General Hospital, two of us (R. D. A. and M. V.) observed three, perhaps four, cases in which the myelin sheaths of all the nerve fibers in the central part of the basis pontis had been destroyed in a single, large, symmetric focus. The nerve cells and axis cylinders were spared for the most part, and the blood vessels were patent and unaffected. There were no signs of inflammation in or near the lesion. The disease had occurred on a background of alcoholism and malnutrition; in the two cases with the largest lesions, it had manifested itself clinically by a pseudobulbar palsy and quadriplegia, leading to death in about 13 and 26 days. In the other two cases References 1. Foix, C., and Hillemand, P.: Contribution à l'étude des ramollissements protubérantiels , Rev. méd., Paris 43:287-305, 1926. 2. Kubik, C. S., and Adams, R. D.: Occlusion of the Basilar Artery—A Clinical and Pathological Study , Brain 69:73-121, 1946.Crossref 3. Adams, R. D., and Kubik, C. S.: Symposium on Multiple Sclerosis and Demyelinating Diseases: The Morbid Anatomy of the Demyelinative Diseases , Am. J. Med. 12:510-546, 1952.Crossref 4. Victor, M., and Adams, R. D.: Unpublished data. 5. Testa, U.: Lesioni del corpo calloso nell'alcoolismo subacuto sperimentale , Riv. sper. freniat. 52:559-574, 1928-1929. 6. Victor, M., and Adams, R. D.: Unpublished data. 7. King, L. S., and Meehan, M. C.: Primary Degeneration of the Corpus Callosum (Marchiafava's Disease) , Arch. Neurol. & Psychiat. 36: 547-568, 1936. 8. Gruner, J. E.: Sur la pathologie des encéphalopathies alcooliques , Rev. neurol. 94:682-689, 1956. 9. Girard, P. F.; Garde, A., and Devic, M.: Considérations terminologiques, étiologiques, anatomiques et cliniques concernant l'encéphalopathie de Gayet-Wernicke, ses rapports avec le syndrome de Marchiafava-Bignami et la psychose de Korsakow , Rev. neurol. 88:236-248, 1953. 10. Garde, A.; Girard, P. F., and Pallasse, A.: L'Encéphalopathie hémorragique de Gayet-Wernicke et la dégénérescence subaiguë du corps calleux de Marchiafava-Bignami: A propos d'une observation anatomo-clinique , Rev. Lyon. méd. 1:99-108, 1952. 11. Schwob, R. A.; Gruner, J.; Foucquier, E.; Harl, J. M.; Françon, J., and Guerre, J.: Sur trois cas de syndrome confusionnel avec contracture chez des éthyliques: Le Problème des encéphalopathies carentielles , Rev. Neurol. 88:174-190, 1953. 12. Estrada, R., and Fuste, F.: Encefalopatía alcohólica: estudio de un caso en que se combinan los caracteres patológicos de la enfermedad de Marchiafava y los de la polioencefalitis de Wernicke , Arch. hosp. Univ., Habana 4:371-390, 1952. 13. Delay, J.; Boudin, G.; Brion, S., and Barbizet, J.: Étude anatomo-clinique de huit encéphalopathies alcooliques: encéphalopathie de Gayet-Wernicke et syndromes voisins , Rev. neurol. 94:596-601, 1956, Case 7.

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Feb 1, 1959

References