中国医科大学神经病学英文课件 Infections of Central Nervous Syetem.pptVIP

Infections of Central Nervous System Section one: Survey Ⅰ.concept : all kinds of pathogens of organisms intrude into cerebral parenchyma, cerebral membrane, vasculature et.al ,causing acute or chronic disease of inflammation . Ⅱ.pathogen virus 、 bacteria 、 spirochet、 worms、 rickettsia、prion. Ⅲ Infection’site 1.parenchyma: encephalitis , myelitis encephalomyelitis. 2.meninges: meningitis, pachymeningitis. 3.both of parenchyma and meninges : meningoencephalitis. Ⅳ Infection’s pathway 1.infection through circulation 2.direct infection : trauma ,otitis media 3.retrograde along peripheral nerves Section two herpes simplex virus encephalitis Ⅰ.concept: It is inflammation of the brain parenchyma, caused by herpes simplex virus. Ⅱ etiology and mechanism 1.etiology: HSV, HSV is a neurotrophic DNA virus (Ⅰ、Ⅱmold ) 2. mechanism: HSV-Ⅰ：90 percent 1) Original onset 2) succeed onset HSV-Ⅱ: 6 to 15 percent , neonate Ⅲ pathology 1 .hemorrhagic necrosis: in bilateral temporal , frontal lobe. 2.Cowdry A inclusion: intranuclear eosinophilic inclusion Ⅳclinical manifestation 1. any age and any season ,acute attack. 2 .prodromic symptom 3. mental symptom 4. convulsion 5. disturbance of consciousness 6. focal symptom: 7 .meningeal irritation Ⅴ investigation 1.EEG 2.CT or MRI 3.CSF 4.pathogen of CSF 1) antigen 2) antibody 3) HSV－DNA Ⅵ diagnosis 1 .clinical diagnosis 1) recurrent or recent herpes infection 2) fever, headache, mental symptom convulsion ,disturbance of consciousness , focal signs. 3)CSF ,EEG, CT, MRI 4)responsive to specific antivirus agent 2 definite diagnosis besides the above, the followings are needed 1)CSF: HSV－antigen, HSV－Ab 2)brain biopsy or pathology: Cowdry in intranuclear 3)CSF: the DNA of the HSV(PCR) 4)cerebral tissue or specimen of the CSF:HSV 5)except other viral encephalitis Ⅶ differential diagnosis Ot