头痛 左侧肢体麻木无力

正病历摘要患者女性,47岁,因头痛、左侧肢体麻木无力2月余,于2016年6月27日入院。患者2月余前(2016年4月5日)罹患感冒、情绪激动后出现头痛,呈发作性全头部搏动性剧烈疼痛[视觉模拟评分(VAS)9分],发作频率2~3次/d,持续时间约5 min,发作时无先兆、无恶心呕吐、无视力视野改变等,服用止痛药无明显缓解。2个月前(2016年4月22日)出现左下肢发作性麻木无力,当晚麻木无力呈持续性至不能行走,但能抬离床面,并伴左上肢痉挛(4~5次/d)。第2天     

发作性左侧肢体麻木抽搐

病历摘要患者男性,75岁。主因发作性左上肢麻木3个月、左上肢抽动2 d,于2011年2月5日入北京协和医院神经科接受治疗。患者于3个月前无明显诱因出现发作性左上肢麻木,以左手更为显著,每次发作持续8～10 min,可自行缓解,发作1～2次/d,未曾诊治。发病前2 d出现发作性左侧上肢抽搐,不伴意识障碍、双眼上翻、口角流涎、大小便失禁及肢体无力等症状与体征,持续2～3 min后自行缓解,每日发作20余次;1 d前出现左上肢持续抽搐,不伴意识障碍,但症状     

表现为短暂性脑缺血发作的慢性硬膜外及硬膜下血肿1例报道

1病例 患者,女性,50岁,发作性右上肢无力、麻木伴右侧面部麻木10 d于2003年9月8日入院.患者于入院前10 d开始反复出现右上肢无力、麻木及右侧面部麻木,持续10余min后自行缓解,病初每日发作3～5次,以后逐渐加频,入院前增至日发作10余次.既往有高血压病、糖尿病病史多年.     

顶叶性共济失调性轻偏瘫

同侧皮质脊髓束征合并小脑共济失调由Fisher命名为共济失调性轻偏瘫.本文报告一例顶叶病灶引起共济失调性轻偏瘫.患者: 61岁男性白人,患非胰岛素依赖性糖尿病,1982年2月出现左上肢感觉异常.二维超声心动图示二尖瓣前叶有一血凝块.接受静脉肝素及口服华法令治疗6个月.85年11月2日出现左上肢远端刺痛麻木,伴左上肢无力.查体:神清,左侧鼻唇沟变浅,左上肢远端轻度无力,感觉性失写(a-     

头部CT高信号影伴双眼视力下降发作性肢体抽搐

病例摘要患者男性,49岁。主因右侧上肢无力5个月、视物模糊3个月,加重1周,于2011年7月19日入院。患者于发病前5个月(2011年2月)无明显诱因出现右侧上肢无力、右手持物不能,症状持续约10min后好转。当地医院头部CT检查显示,双侧枕顶叶皮质及皮髓质交界区多发结节、条索状钙化灶,右侧放射冠区及半卵圆中心多发腔隙性梗死及软化灶(图1a),临床拟诊为脑囊虫病。     

发热 头痛 右侧肢体无力 言语含糊

病历摘要患者男性,27岁。主因头痛4个月,发热、右侧肢体无力2个月,言语含糊5d,于2011年5月21日入院。患者于入院前4个月(2011年1月)无诱因出现头痛,不伴发热,不影响日常工作。外院行头部CT检查无异常发现,亦未予以治疗;1个月后(2011年2月底)头痛症状加剧,伴非喷射性呕吐,且间断出现发作性左侧肢体麻木、无力,每次持续约15min(2011年3月初);发病后2个月时(2011年3月底)间断出现视物成双,外院MRI增强扫描(2011年3月28日)显示双侧额上回、小脑半球异常信号,局部软脑膜异常强化(图     

颈椎伸屈位MRI诊断颈椎病

病历摘要 患者男,44岁.主诉“双臂麻木1年,双手肌肉萎缩6个月”入院.患者于1年前无诱因出现双侧前臂麻木,10个月前出现双手麻木,不伴肢体无力、疼痛,未予重视.6个月前出现双手肌肉萎缩,以大鱼际肌为主,症状进行性加重,伴双上肢无力,就诊于当地医院查颈椎MRI检查,回报髓内异常信号,予营养神经等对症治疗,双手麻木明显缓解,余症状无改善,遂收入病房,门诊诊断“颈椎间盘突出”.既往史无特殊,病程中无外伤史.JOA评分16分.     

Solitaire支架取栓治疗急性大脑中动脉闭塞性脑梗死1例报告

<正>1病例报告患者,女,69岁,因"发作性右手麻木、言语不清9 d,加重伴右侧肢体无力7 h"于2014年7月1日01:18入院。患者于6月21日起反复出现发作性右手麻木,每次持续10余分钟,每日发作4~5次;6月28日出现发作性构音障碍。30日18:30上述症状加重,表现为言语不能及右侧肢体麻木无力;头部MRI提示:左侧放射冠、基底节区、颞叶散在多发异     

以短暂性脑缺血发作起病的POEMS综合征1例报道

正1病例介绍患者男性,60岁。主因"发作性左上肢麻木无力伴口齿不清6 d"于2016年5月3日急诊入上海长海医院。患者6 d前无明显诱因突发左手食指、中指和无名指发作性麻木无力、持物不稳,每次持续约30～60 min,可自行缓解,每日发作数次,未重视。入院前1日患者发生口齿不清伴吞咽困难1次,约10 min后完全缓解,于外院就诊并行头颅计算机断层扫描(computed tomography,CT)未见明显异常,为进一步明     

不伴脑病症状的成人急性播散性脑脊髓炎一例

<正>1病例报告患者男,38岁,因"左上肢麻木1个月,加重伴双下肢无力、尿便障碍4d"于2016-05-12收入北京大学第三医院。入院前1个月出现左上肢及左半躯干麻木,就诊于外院骨科,考虑"颈椎病",未予进一步诊治。入院10d前出现左下肢麻木,入院7d前出现右手、右足针刺样麻木,入院4d前突发小便潴留,于外院留置尿管,入院3d前出现右侧躯干及右下肢麻木,入院2d前出现右下肢无力,入院1d前就诊于本院急诊,查颈椎MRI示第2~3颈椎水平     

Differential cognitive responses to guqin music and piano music in Chinese subjects： an event-related potential study

Objective To compare the cognitive effects of guqin （the oldest Chinese instrument） music and piano music. Methods Behavioral and event-related potential （ERP） data in a standard two-stimulus auditory oddball task were recorded and analyzed. Results This study replicated the previous results of culture-familiar music effect on Chinese subjects： the greater P300 amplitude in frontal areas in a culture-familiar music environment. At the same time, the difference between guqin music and piano music was observed in NI and later positive complex （LPC： including P300 and P500）： a relatively higher participation of right anterior-temporal areas in Chinese subjects. Conclusion The results suggest that the special features of ERP responses to guqin music are the outcome of Chinese tonal language environments given the similarity between Guqin＇s tones and Mandarin lexical tones.     

氧化应激与认知功能障碍的研究进展

氧化应激（Oxidative Stress）不仅在糖尿病、高血压病等身心疾病中起着重要作用,而且对阿尔茨海默病（AlzheimerDisease,AD）、帕金森病（Parkin-son Disease,PD）等神经精神障碍的认知功能也有一定影响。强烈或持续性的氧化应激可通过诱导细胞凋亡和炎性反应导致细胞、组织损害。流行病学及动物研究均表明,母孕期遭受应激可能会影响胎儿的神经心理发育过程,造成胎儿大脑某区域的缺陷,引起持续性认知改变、神经内分泌和行为反应,增加后代精神疾病的患病风险。现对氧化应激与认知功能障碍的机制进行综述。     

Chaotic electrical stimulation of the subthalamic nucleus – mossy fiber sprouting, epileptic seizures, and brain electrical activity in pentylenetetrazol-kindled rats★

BACKGROUND： Previous studies have demonstrated that appropriate interventions can alter brain electrical activity of epileptic patients prior to and during a seizure, leading to maintenance of a highly chaotic state, thereby inhibiting abnormal epileptic discharges, and eventually controlling epileptic seizure. OBJECTIVE： This study was designed to observe the effects of chaotic electrical stimulation to the subthalamic nucleus on mossy fiber sprouting, epileptic seizures, and electrical discharges, and to summarize the most suitable intervention. DESIGN, TIME AND SETTING： This randomized grouping, neuroelectrophysiological study was performed at the Laboratory of Neurology, Union Hospital Affiliated to Fujian Medical University in September 2007. MATERIALS： Fifty-five healthy, male, Sprague Dawley rats were subjected to an epileptic model by an intraperitoneal injection of pentylenetetrazol. The YC-2 programmed electrical stimulator was provided by Chengdu Instrument Factory, China; the video electroencephalographic system （KT-88-2400） and 24-hour active electroencephalographic system were products of Contec Medical System Co., Ltd., China; pentylenetetrazol was purchased from Sigma, USA. METHODS： The present interventional method consisted of electrical stimulation to the subthalamic nucleus with an intensity of 500 μA, pulse width 0.05 ms, frequency 30 Hz, and a duration of 20 minutes for 14 successive days. Fifty-five rats were divided into 6 groups： （1） pre-stimulation （n = 10）, pentylenetetrazol was administered and 30 minutes later, chaotic electrical stimulation was performed; （2） synchronous stimulation （n = 10）, rats received pentylenetetrazol and chaotic electrical stimulation concurrently; （3） post-administration stimulation （n = 10）, after pentylenetetrazol administration, chaotic electrical stimulation was performed immediately after cessation of a seizure; （4） sham-stimulation （n = 10）, following pentylenetetrazol administration, an electrode was con     

Effect of Ganoderma lucidum spore on expression of insulin-like growth factor-1, nuclear factor-kappa B, and neuronal apoptosis in the epileptic rat brain*★

BACKGROUND：It has been reported that Ganoderma lucidum spore powder, a very well known Chinese traditional medicine, can affect immunoregulation, free radical scavenging, and anti-hypoxia responses. OBJECTIVE： To investigate the effect of Ganoderma lucidum spore powder on expression of insulin-like growth factor-1 （IGF-1）, nuclear factor-κB （NF-κB） and neuronal apoptosis in rats with pentylenetetrazol （PTZ）-induced epilepsy. DESIGN, TIME AND SETTING： A cellular and molecular biology experiment with randomized controlled study design was performed at the Central Laboratory of Basic Medical College of Jiamusi University from June to August 2005. MATERIALS： Thirty healthy, adult, male, Wistar rats were selected and randomly divided into 3 groups （10 rats per group）： control, epilepsy model, and Ganoderma lucidum spore powder. A sub-eclampsia PTZ dose （35 mg/kg） was intraperitoneally injected to induce epilepsy in the latter two groups. Wild Ganoderma lucidum spore powder （30 g/L） was provided by the wild Ganoderma lucidum plant nursery at Jiamusi, China. Immunohistochemical detection and terminal deoxynucleotidyl transferase-mediate dUTP nick end-labeling （TUNEL） kits were purchased from Wuhan Boster Biological Technology Co., Ltd., China. METHODS： Ganoderma lucidum spore powder was intragastrically administered at a dose of 10.0 mL/kg, once a day for 28 days. In the epilepsy and control groups, an equivalent volume of normal saline was intragastrically administered. MAIN OUTCOME MEASURES： Immunoreactivity for IGF-1 and NF-κB/P65 were detected by immunohistochemical staining. Neuronal apoptosis was detected using TUNEL methods. RESULTS： The hippocampus and cerebral cortex of rats with PTZ-induced epilepsy exhibited a higher number of apoptotic cells at high magnification （×400）, compared with the control group. Expression of IGF-1 and NF-κB were higher in the epilepsy group, compared with the control group （P 〈 0.01）. In Ganoderma lucidum spore-treated rats,     

Effects of acrous gramineus and its component, alpha-asarone, on apoptosis of hippocampal neurons after seizure in immature rats**☆

BACKGROUND： α-asarone and acrous gramineus have been shown to play a necessary function in enhancing the reactivity and convulsant threshold to electric stimulation of immature rats. They have also been shown to effectively suppress epileptic seizures induced by pentylenetetrazol in young rats. However, the mechanisms for these roles have been still unclear. OBJECTIVE： To observe the effects in immature rats of acrous gramineus and α -asarone on apoptosis of hippocampal neurons after epileptic seizure at the protein level, and to analyze the mechanism for these effects. DESIGN： A randomized controlled animal experiment. SETTINGS： Department of Pediatrics, First Hospital of Jilin University; Department of Histology and Embryology, Norman Bethune Medical School of Jilin University; Department of Internal Medicine, Children＇s Hospital of Changchun City; Department of Neurology, First Clinical Hospital affiliated to Harbin Medical University. MATERIALS： Fifty 3-week old Wistar rats, 34-40 g, irrespective of gender, were provided by Gaoxin Research Center of Medical Animal Experiment, Changchun. The animals were treated according to the animal ethical standards. The following chemicals were used for this study： acrous gramineus powders or infusion （Batch No, 0307113, Tianjiang Medicine Company Limited, Jiangyin）, α-asarone tablets （Batch No. 030219, Tianwei Pharmaceutical Factory, Shenyang）, and phenobarbital sodium tablets （Batch No. 020608, Xinya Medicine Company Limited, Shanghai）. The animals were divided into five groups randomly. First, ten rats were chosen as the normal controls. The remaining rats were treated with i.p. injections of pentylenetetrazol to stimulate an epileptic model. METHODS： The experiments were performed at the Neurological Laboratory of the First Hospital of Jilin University between October and December 2004. The rats were treated with i.p. injections of pentylenetetrazol （60 mg/kg） to establish an epileptic model. According to Racine＇ s standard, animal     

Influence of Ginkgo Biloba extract on beta-secretase in rat hippocampal neuronal cultures following chronic hypoxic and hypoglycemic conditions

BACKGROUND： Preparation of Ginkgo leaf has been widely used to improve cognitive deficits and dementia, in particular in Alzheirner＇s disease patients. However, the precise mechanism of action of Ginkgo leaf remains unclear. OBJECTIVE： To explore the effect of Ginkgo Biloba extract （Egb761）, Ginaton, on β -secretase expression in rat hippocampal neuronal cultures following chronic hypoxic and hypoglycemic conditions. DESIGN, TIME AND SETTNG： Completely by randomized, grouping study. The experiment was performed at the Laboratory of Molecular Imaging, Southeast University between August 2006 and August 2007. MATERIALS： A total of 128 Wistar rats aged 24 hours were selected, and hippocampal neurons were harvested for primary cultures. METHODS： On day 7, primary hippocampal neuronal cultures were treated with Egb761 （0, 25, 50, 100, 150, and 200μg/mL） under hypoxic/hypoglycemic or hypoglycemic culture conditions for 12, 24, and 36 hours, respectively. Hippocampal neurons cultured in primary culture medium served as control. MAIN OUTCOME MEASURES： Cell viability was assayed using 3-（4,5-Dimethylthiazol-2-yl）- 2,5-diphenyltetrazolium bromide （MTT）; fluorescence detection of β -secretase activity was performed; Western Blot was used to measure β -secretase expression. RESULTS： Cell viability under hypoxic/hypoglycemic or hypoglycemic culture conditions was significantly less than control cells （P 〈 0.05）. Under hypoxic/hypoglycemic or hypoglycemic culture conditions, treatment with 25 μg/mL Egb761 did not alter cell viability. However, 〉 25 μg/mL Egb761 induced greater cell viability （P 〈 0.05）. No differences were observed between hypoxic/hypoglycemic or hypoglycemic cells （P 〉 0.05）. α -secretase activity was increased after 12 hours in hypoxic/hypoglycemic culture （P 〈 0.01）. There were no significant differences between the 12-, 24-, or 36-hour Egb761 groups and the hypoxic/hypoglycemic groups （P 〉 0.05）. β -secretase activity was greater after     

Effect of bilobalide B on cholinergic hippocampal neurons exposed to cholesterol and apolipoprotein E4*☆

BACKGROUND： Extracts of ginkgo biloba leaves have been reported to improve nerve function and activity in Alzheimer＇s disease, which is associated with reduced secretion of cholinergic neurotransmitter in hippocampal neurons. OBJECTIVE： To validate the protective effect of bilobalide B against in vitro injury of cholinergic neurons of the hippocampus induced by combined cholesterol and apoE4 DESIGN, TIME AND SETTING： This randomized, controlled animal experiment was performed in the Pathology Laboratory, Tianjin University of Traditional Chinese Medicine from July 2003 to July 2006. MATERIALS： Neonatal Wistar rats, 1-day-old, both male and female, and mean body mass of 5 g were selected for this study. Cholesterol and apolipoprotein E4 （apoE4） were purchased from Sigma Company （USA）, bilobalide B was purchased from Tianjin Zhongyi Pharmaceutical Factory, batch number 20050312. METHODS： Hippocampal neurons were divided into three groups： a normal control group （routinely added media）, a model group （exposed to media containing 40 mg/L cholesterol and 30 mg/L apoE4 for 24 hours） and a bilobalide B group （exposed to media containing 160 mg/L bilobalide B for 16 hours, and then with addition of 40 mg/L cholesterol and 30 mg/L apoE4 for an additional 24 hours）. MAIN OUTCOME MEASURES： Levels of acetylcholine （ACh） and activity of acetylcholinesterase （ACHE） and choline acetyltransferase （CHAT） in hippocampal neurons were determined by microdosage hydroxylamine colorimetry, hydroxylamine colorimetry and radiological chemistry, respectively. RESULTS： The ACh level was significantly lower in the model group than that in the normal control group （P 〈 0.01）, while it was markedly higher in the bilobalide B group than in the model group （P 〈 0.05）. Activity of AChE was significantly decreased in the model group compared with the normal control group （P 〈 0.05）. However, there was no significant difference between the model group and the bilobalide B group ?     

癫癇社区防控策略可使更多农村地区癫癇患者受益

癫癇是一种临床常见的神经系统疾病。常于儿童和青少年期发病,若不接受正规治疗可反复发作,甚至迁延终身。该病不仅严重影响患者本人身体和心理健康,也给其家庭带来巨大痛苦和沉重的经济负担。据估计,全球约有逾50×106例癫癇患者,其中80%在发展中国家,发展中国家癫癇患病率是发达国家的2~3倍,且60%~90%的患者未接受治疗或仅接受非正规治疗[1-2]。癫癇的高患病率、高病死率及其对患者身心造成的严重不良影响已引起社会各界的重视,针对癫癇的各方面研究正在不断加强,     

Effect of propofol on glutamate-induced activation and related inflammatory cytokines of astrocytes from spinal cord dorsal horn★

BACKGROUND： Astrocytes participate in central nervous system-mediated physiological or pathological processes, such as pain. Activated dorsal horn astrocytes from the spinal cord produce nerve active substances and proinflammatory cytokines, such as interleukin-lbeta （IL-1 β ）, IL-6, and tumor necrosis factor- α （TNF-α ）, which play important roles in pain transduction and regulation. OBJECTIVE： To investigate the effects of different doses of propofol on activation of cultured spinal cord dorsal horn astrocytes induced by glutamate, as well as changes in IL-1β, IL-6, and TNF- α, and 1L-10 （anti-inflammatory cytokine） expression in rats, and to explore the dose relationship of propofol. DESIGN, TIME AND SETTING： The cellular and molecular biology experiment was performed at the Central Laboratory of Yunyang Medical College between March 2006 and December 2007. MATERIALS： Forty healthy, Wistar rats, aged 2-3 days, were selected. Propofol was provided by Zeneca, UK; glutamate by Sigma, USA; EPICS XL flow cytometry by Beckman culture, USA; rabbit-anti-mouse glial fibrillary acidic protein （GFAP） antibody kit and inflammatory cytokine detection kit were provided by Zhongshan Biotechnology Company Ltd., Beijing; multimedia color pathologic image analysis system was a product of Nikon, Japan. METHODS： Astrocytes were harvested from T11- L6 spinal cord dorsal horn of Wistar rats and incubated for 3 weeks. The cells were divided into seven groups, according to various treatment conditions： control group was cells cultured in Hank＇s buffered saline solution; intralipid group was cells cultured in intralipid （0.2 mL/L）; glutamate group was cells cultured with 100 u mol/L glutamate; propofol group was cells cultured with 250 u mol/L propofol; three glutamate plus propofol groups were cultured in 100 11 mol/L of glutamate, followed by 5, 25, and 250 u mol/L of propofol 10 minutes later. MAIN OUTCOME MEASURES： GFAP-labeled astrocytes were analyzed using a multimedia pathology imaging a