儿童重症病毒性脑炎临床诊治分析

目的 探讨儿童重症病毒性脑炎的诊断与治疗。方法 对40例重症病毒性脑炎患儿的临床资料进行回顾性分析。结果 22例痊愈，10例好转，6例放弃治疗，2例死亡。结论 临床表现是早期诊断的重要依据，脑电图可作为早期诊断手段之一。影像学结果与病情转归及预后不呈平行关系。治疗的关键在于早期及时抗病毒，足量足程激素及丙种球蛋白应用可有效改善预后。     

恙虫病脑膜炎和脑炎6例诊治体会

恙虫病以中枢神经系统损害为突出表现较为少见.我院自1995年9月～1997年9月收治恙虫病28例,其中并脑膜炎和脑炎6例,现分析报道如下.     

60例急性病毒性脑炎的诊治体会

病毒性脑炎是由多种病毒包括单纯疱疹病毒 ,带状疱疹病毒 ,肠道病毒 ,腺病毒 ,森林病毒 ,狂犬病毒等引起 ,如不及时诊治 ,将留下神经系统后遗症 ,严重者甚至危及生命。目前治疗尚无统一标准 ,现将我科 1995年 7月至 2 0 0 0年 7月收治的 6 0例急性病毒性脑炎诊治分析报道如下。1　临床资料1.1　一般资料　 6 0例患者中 ,男性 41例 ,女性 19例 ,年龄14～ 5 5岁 ,平均 33.5岁 ,均符合急性病毒性脑炎诊断标准 [1 ] 。1.2　临床表现　 6 0例患者中 ,发热 5 1例 ,其中高热 2 8例 ,头痛、呕吐 46例 (其中喷射状呕吐 15例 ) ,意识障碍 43例 ,其中昏…     

流行性腮腺炎脑炎与脑膜脑炎的临床诊断和治疗分析

我院收治了39例流行性腮腺炎脑炎与脑膜脑炎患儿。其中均有流行性腮腺炎接触史，有血或尿淀粉酶升高，或血、尿淀粉酶均高。脑电图均有改变，头CT未见异常改变，现报告如下。     

小儿病毒性脑炎30例诊治分析

目的：探讨小儿病毒性脑炎的诊治方法。方法：对36例小儿病毒性脑炎的临床资料进行回顾性分析。结果：全组36例中治愈30例,好转5例,死亡1例。结论：依据流行病学资料、临床表现及辅助检查等综合分析进行早期诊断,积极进行抗惊版、降颅压、抗病毒及营养脑细胞等有效的综合治疗,可提高治愈率,降低病死率,减少后遗症。     

400例儿童病毒性脑炎回顾分析

1993年和1994年夏秋季，我县小儿急性病毒性脑炎流行。发病集中，较多．占同期发热病例16％。临床症状表现较轻，预后良好。现将临床资料较完整的400例作一分析。     

儿童病毒性脑炎的诊断与治疗

病毒性脑炎系指病毒感染引起的脑实质的炎症。引起病毒性脑炎的病毒种类较多，而且不断有新的病毒被发现，发病率有逐年增加趋势，根据其流行特征、传播途径不同，一般将病毒性脑炎分为两种类型：①流行性病毒性脑炎。此型脑炎有明显的流行特征，经虫媒病毒或蜱传播，其主要病毒包括黄病毒科的虫传病毒，在我国主要为流行性乙型脑炎和森林脑炎。②散发性脑炎。本型脑炎不经虫媒或蜱传播，呈散发性发生，有时可呈流行性发生。病毒包括肠道病毒(柯萨基病毒、埃可病毒以及肠道病毒68～71型等)。疱疹病毒科病毒(单纯疱疹病毒、水痘一带状疱疹病毒、EB病毒等)。副黏病毒属病毒(麻疹病毒、风疹病毒、流行性腮腺炎病毒)以及近年来在马来西亚尼帕(Nipah)小镇发现Nipah病毒。     

小儿病毒性脑炎62例诊治体会

小儿病毒性脑炎(病脑)为较常见的中枢神经系统感染,常急性起病,诊治得当与否直接影响预后。我院2001年1月~2005年12月收治小儿病脑62例,现回顾分析诊疗过程如下。1临床资料1.1一般资料本组男38例,女24例;年龄6个月~13岁。53例有前驱呼吸道、消化道症状及发热(体温37.5~41.5℃),     

肺结核继发结核性脑炎及脑膜炎45例临床诊治体会

目的:探讨肺结核合并结核性脑炎及脑膜炎的临床特点及治疗体会。方法:回顾性分析肺结核合并结核性脑炎及脑膜炎患者45例的临床表现、实验室检查、影像学特点、治疗方案及疗效、预后等。结果:本组患者均有肺结核病史,合并中枢神经系统症状,脑脊液呈特征性改变,抗酸染色及结核分枝杆菌培养阳性率低,影像学可见相应改变,抗痨治疗有效。本组临床治愈32例,有神经系统后遗症7例,死亡6例。结论:肺结核合并结核性脑炎及脑膜炎临床表现多样,中枢神经系统损害大,病程长,治疗难度大,预后不良。     

《2020年中国肠易激综合征专家共识意见》解读

肠易激综合征(irritable bowel syndrome,IBS)是临床常见慢性病,近年来对其认识不断更新.2020下半年,中华医学会消化病学分会胃肠功能性疾病协作组号召国内多名专家组织制订了《2020年中国肠易激综合征专家共识》,该共识意见在2015年共识的基础上对肠易激综合征的定义与病因、流行病学、发病机制、...     

Diagnosis and treatment of venous malformations in China: consensus document

Venous malformations (VMs) are the most common vascular developmental anomalies. There are many controversies over VMs in Chinese clinical medical practice. Experts on the panel from vascular-anomaly centers in China reviewed the etiology, pathophysiology, epidemiology, classification, clinical presentations, diagnosis, and treatment of VMs. The aim of this consensus document is to provide recommendations for, and assist clinicians and patients in, the diagnosis and treatment of VMs.     

炎症性肠病诊断与治疗的共识意见(2018年，北京)：克罗恩病部分解读

2018年5月,中华消化杂志在线发表了中华医学会消化病学分会炎症性肠病学组制订的《炎症性肠病诊断与治疗的共识意见(2018年,北京)》,该共识意见在2012年共识意见的基础上对炎症性肠病的诊治进展进行了更新与完善,为医务人员规范诊治炎症性肠病提供了更新、更全面的依据。本文主要对共识意见中克罗恩病（Crohn's disease, CD）的诊断和治疗部分进行解读,以期加深临床医师对新共识的理解,提高CD的诊治水平。     

炎症性肠病诊断与治疗的共识意见(2018年，北京)溃疡性结肠炎部分解读

2018年5月,中华消化杂志在线发表了中华医学会消化病学分会炎症性肠病学组制订的《炎症性肠病诊断与治疗的共识意见(2018年,北京)》,该共识意见在2012年共识意见的基础上对炎症性肠病的诊治进展进行了更新与完善,为医务人员规范诊治炎症性肠病提供了更新、更全面的依据。本文主要对共识意见中溃疡性结肠炎的诊断和治疗部分进行解读,以期加深临床医师对新共识的认识与理解,提高溃疡性结肠炎的诊治水平。     

病毒性脑炎患儿肢体运动功能障碍的康复治疗

目的探讨康复治疗对病毒性脑炎患儿肢体运动功能障碍恢复的影响。方法采用综合康复治疗技术,并配合传统针刺疗法和按摩疗法,对病毒性脑炎肢体运动功能障碍患儿进行了临床对照性研究。运动功能用Fugl－meyer评分,痉挛用Ashworth痉挛级评分。结果患肢运动功能恢复康复组明显优于对照组(P<0.005),康复组疗效明显优于对照组(P<0.01)。结论恢复早期康复治疗可以明显提高病毒性脑炎患儿的运动功能,减少其功能残疾的发生,有效地恢复其生活自理能力。     

Tick-borne encephalitis in children: an update on epidemiology and diagnosis

Tick-borne encephalitis is an infection of the CNS caused by a tick-borne encephalitis virus transmitted by ticks. It is more common in adults than in children. During the last 30 years, the incidence of the disease increased continuously in almost all endemic European countries except Austria. Many factors are responsible for the increased incidence. However, in Austria, the incidence of tick-borne encephalitis decreased dramatically since the introduction of a well-organized vaccination campaign against tick-borne encephalitis. The diagnosis of tick-borne encephalitis is based on clinical criteria and laboratory confirmation of infection. Other tick-borne diseases, such as Lyme borreliosis and human granulocytic anaplasmosis, should be considered in children with tick-borne encephalitis since endemic areas for all three diseases overlap.     

儿童重症免疫性脑炎临床特征和治疗分析

目的:总结儿童重症免疫性脑炎（AE）的临床特征、影像学和脑电图变化以及治疗和预后。方法:回顾性研究,对象为2017年6月至2020年5月上海交通大学附属儿童医院重症监护病房（PICU）收治的重症AE,分析临床资料、治疗及预后情况。结果:AE患儿合计27例,其中女性18例（66.7%）。首次发病年龄为（7.9±3.2）岁...     

French guidelines for the diagnosis and management of migraine in adults and children

BACKGROUND: The French Recommendations for Clinical Practice: Diagnosis and Therapy of Migraine are guidelines concerning the overall management of patients with migraine, including diagnostic and therapeutic strategies and assessment of disability. OBJECTIVE: This article summarizes the guidelines as they apply to adults and children, and proposes future direction for steps toward optimal treatment of migraine in patients in France. METHODS: The recommendations were categorized into 3 levels of proof (A-C) according to the National Agency for Accreditation and Evaluation in Health (ANAES) methodology and were based on a professional consensus reached among members of the Working Group and the Guidelines Review Group of the ANAES. RESULTS: The International Headache Society diagnostic criteria for migraine should be used in routine clinical practice. Recommended agents for the treatment of migraine in adults include nonsteroidal anti-inflammatory drugs, acetylsalicylic acid (ASA) monotherapy or in combination with metoclopramide, acetaminophen monotherapy, triptans, ergotamine tartrate, and dihydroergotamine mesylate. Patients should use the medication as early as possible after the onset of migraine headache. For migraine prophylaxis in adults, the following can be used: propranolol, metoprolol, oxetorone, or amitriptyline as first-line treatment, and pizotifen, flunarizine, valproate sodium, or topiramate as second-line treatment. Migraine in children can be distinguished from that in adults by shorter duration (2-48 hours in children aged <15 years), more frequent bilateral localization, frequent predominant gastrointestinal disturbances, and frequent pallor hailing the onset of the attack. The following drugs are recommended in children and adolescents: ibuprofen in children aged >6 months, diclofenac in children weighing >16 kg, naproxen in children aged >6 years or weighing >25 kg, ASA alone or in combination with metoclopramide, acetaminophen alone or in combination with metoclopramide, and ergotamine tartrate in children aged >10 years. CONCLUSIONS: These guidelines are intended to help general practitioners to manage migraine patients according to the rules of evidence-based medicine.     

病毒性脑炎的早期诊断和治疗

目的探讨病毒性脑炎的早期临床诊断和治疗。方法对38例病毒性脑炎患者的临床资料进行回顾性研究分析。结果病毒性脑炎早期主要临床表现以发热(占94.74%)、头痛(占92.11%)、精神症状(占47.37%)为主。脑电图异常率73.68%。结论病毒性脑炎的早期诊断主要依赖临床表现、脑电图检查、脑脊液检查及头颅CT或MRI检查。一旦考虑病毒性脑炎,宜尽早抗病毒治疗,治疗时间以临床症状改善为标准。     

N-methyl-D-aspartate receptor encephalitis: laboratory diagnostics and comparative clinical features in adults and children

Introduction: N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common autoimmune encephalitis due to autoantibodies against neuronal surface antigens, can affect both children and adults, leading to neurological and neuropsychological sequelae. However, it is potentially treatable and the prompt start of immunotherapy associates with better prognosis. Conversely, misdiagnosis can be harmful. The detection of NMDAR antibodies in serum and cerebrospinal fluid plays a pivotal role in the diagnostic work-up. Reliable methods for NMDAR antibody detection are thus fundamental to assure accurate diagnosis and allow early treatments.

Areas covered: This review recapitulates the pathogenic mechanisms of NMDAR encephalitis as a model of antibody mediated synaptopathy, and gives insights into the related state-of-the-art laboratory testing. The differences in clinical presentations, tumor associations and responses to treatments between adults and children are also described.

Expert commentary: The relevance of NMDAR encephalitis has placed neuroimmunology laboratories in a crucial position, but methods for NMDAR antibody detection are awaiting thorough and consensus-based standardizations. In the next few years, this process, along with novel insights into the pathogenic mechanisms, could improve the disease management and clarify the still pending role of NMDAR antibodies in healthy people and in other more common neuropsychiatric disorders.