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Objective To analyze the clinical manifestations and imaging features of human brainstem encephalitis with Parkinson syndrome as the main manifestations. Methods Combined with related literature, the clinical, laboratory and imaging features of three patients with brainstem encephalitis, which were mainly manifested as Parkinson syndrome, were analyzed. Results The 3-hour video EEG showed normal in 2 cases and abnormal in one case with more delta wave in each leads. Cerebrospinal fluid examination revealed normal cell numbers in one case, increased cell numbers in 2 case and elevated cerebrospinal fluid proteins in all 3 cases. serum and CSF IgG anti-NMO antibodies as well as autoimmune encephalitis antibodies were negative in 3 cases. Brain MRI showed symmetrical abnormal signal in bilateral midbrain and pia mater enhancement increased in 3 cases. After hormone, and madopar treatment, Parkinson syndrome symptoms were significantly improved in two patients. Conclusion Brainstem encephalitis-induced symmetrical midbrain lesion can manifest as Parkinson syndrome. The laboratory tests reveal an involvement of immune system and hormone therapy may be effective.
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Objective To investigate the clinical features of patients with neuromyelitisoptica spectrum disorders (NMOSD) in China.Methods Cases reports of NMOSD from 1989 to 2016 were retrieved from the database of Weipu data basis,and the clinical features of cases reported were analyzed.Results Eighty-seven studies were enrolled.Totally 109 patients were included.The ratio of male to female was 1 ∶ 4 and the mean onset age was (38.44 ± 17.08) years (range 5-76 years).The predisposing factors was catching a cold(12.80％).There were 66.05％ patients with optic neuritis symptoms as initial symptoms,23.85％ with spinal cord inflammation as the first symptom.Spinal magnetic resonance showed that 80.73％ of the lesions involved thoracic spinal cord,and the cervical spinal cord occupied by 49.54％,while the lumbar spine accounted for about 10.09％.12.84％ involved the final area.Conclusion In China,NMSOD is common in young adults,and more common in women.The onset age between the male and female has no significant difference.The first symptom of optic neuritis is more common,and the spinal cord lesion in thoracic cord is popular.