神经内科英文课件-脱髓鞘疾病

Paroxysmal symptoms Ⅴ,etal.
3.Characteristic signs
(1) internuclear ophthalmoplegia(INO)
(2) nystagmus
4.Clinical type
a. Alternative recurrent-remit type b. Secondary progressive type c. Primary progressive type d. Progressive recurrent type e. Benign type
2.symptom
symptoms
Affected structures
Weakness of one or more limbs
Corticospinal tract(UMN)
Loss of vision (optic neuritis)
Optic nerve(Ⅱ)
Ophthalmoplegia ,nyst Brain stem :the
2.Brain evoked potential(BEP) VEP,BAEP,SEP. detect subclinical lesions
3.CT:multiple low density lesion white matter 4.MRI:the most sensitive means a.multifocal long T1 and long T2 signals b.paraventricle,half-oval area,brain stem,cerebellum,spinal cord,corpus callosum c.Enlarged ventricle
Ⅱ.Etiology and pathogenesis
1.Viral infection and auto-immune reaction.
2.Genetic factor: inherited predisposition.
3.Environmental factor.
Ⅲ .Pathology
Ⅴ.Investigation
1.CSF (1)Routine and biological examination cell: normal or slightly high, <15 protein:slightly high (2)IgG:characteristic a.CSF-IgG index: [CSF-IgG/S-IgG]/[CSF-ALB/S-ALB]>0.7 b.oligoclonal bands of IgG(OB):95%
3.Phase (1)acute phase: (2)chronic phase
Ⅳ.Clinical Features
1.General condition: onset: acute or subacute age:10-50 precipitating factor characteristic of duration:alternative recurrent-remit
Demyelinating Diseases 脱髓鞘疾病
Multiple Sclerosis
Ⅰ.Definition MS is an auto-immune disease.It is
characterized by multifocal demyelination in the white matter of the central nervous system.
1.Multiple demyelination in the white matter of the central nervous system.
2.Site:round the lateral ventricle ; optic nerve ;brain stem ;spinal cord ;cerebellum
agmus and diplopia. longitudinal fasciculus,
one and
PPAF,Ⅲ,Ⅳ,Ⅵ
A half syndrome
2.symptom
symptoms
Affected structures
Nystagmus
Cerebellum, vestibular nuclei
ataxia
Cerebellum
Sensory dysfunction
Spinothalamic tract
(conveying tract type) Posterior funiculus
※Lhermitte’s sign:an electric shock-like sensation on flexion of the neck
CDMS CPMS LSDMS LSPMS
Ⅵ.Diagnosis
Number of Clinical
attacks
focus
2
2
2
1
2
1
1
2
1
1
2
1
1
2
1
1
2
Subclinical CSF/IgG evidence
and 1
2.Brain evoked potential(BEP) VEP,BAEP,SEP. detect subclinical lesions
3.CT:multiple low density lesion white matter 4.MRI:the most sensitive means a.multifocal long T1 and long T2 signals b.paraventricle,half-oval area,brain stem,cerebellum,spinal cord,corpus callosum c.Enlarged ventricle
2.symptom
symptoms
Affwk.baidu.comcted structures
Mental symptoms: depression;euphoria; dementia
Paraventicular white matter
Bladder and bowel dysfunction
Spinal cord