[Central pontine XXXX after liver transplantation. Report of five cases].

@entity1 @entity1688 @entity99 @entity2003 @entity75 @entity4 @entity16 @entity6150 @entity427
BACKGROUND: Central Pontine @entity6150 (CPM) is the most severe @entity16 after liver transplantation and apparently is not related to changes in osmolarity. AIM: To report five transplanted @entity1 with CPM. @entity1 AND METHODS: In a series of 27 @entity1 subjected to liver transplantation between 2005 and 2008, we found five @entity1 who developed CPM. RESULTS: All @entity1 presented a severe @entity99 . In the absence of alterations in osmolality, they developed, between the second to seventh day after transplantation, a central @entity1688 , @entity427 and Babinski sign, with preservation of sensorium. Magnetic resonance imaging showed demyelination of the motor pathway only in the protuberance. Motor recovery first began in the fingers and hands, followed by forearms, toes, feet, arms and finally the legs, defining a somatotopic recovery of the cortico-spinal pathway. CONCLUSIONS: This form of regaining motility shows that the selective involvement of the pyramidal tract in CPM, is according to its location in the pons and suggests a local entrapment. It is due to the structural @entity2003 of the protuberance that limits the expansive requirements of cytotoxic and vasogenic @entity4 , and only affects the long fibers of cortico-spinal tracts, sensitized by @entity75 . The entrapment syndromes generally preserve the axons, injure myelin and have no inflammatory reactions.
