We report here a case of myelitis of the cervical spinal cord in a 59-year-old woman presented with right arm weakness and numbness. Cervical myelitis developed three weeks after the eruption of zoster rash from the C2 to C5 dermatomes. The serum aquaporin-4 antibody was detected using the cell based transfection immunofluorescence assay. MRI of the cervical spine revealed abnormal cord signal. Cerebrospinal fluid analysis demonstrated varicella-zoster virus DNA was not detected. The patient was diagnosed with neuromyelitis optica spectrum disorder, supporting the hypothesis that the pathogenesis of neuromyelitis optica spectrum disorders is triggered by infection.

Objective To study the association between blood glucose control and mild cognitive impairment (MCI) in patients with diabetes mellitus and small-artery occlusion (SAO).Methods A screening study of cognitive impairment was conducted in the 676 patients diagnosed with SAO who had been treated at Department of Neurology,Huanhu Hospital from January 2010 through June 2017.They were divided into a normal cognition group (n=629) and an MCI group (n=47) according to the screening results.They were also divided into 4 groups according to their history of diabetes and levels of hemoglobin Alc:normal blood glucose group (n=398),stringent goals group (n=59),general goals group (n=46) and goals-not-met group (n=173).The differences were compared in terms of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) scores between the normal blood glucose,stringent goals,general goals and goals-not-met groups.We also analyzed the general clinical data and risk factors between the normal cognition and MCI groups.Variables of confounders that were identified as significant were entered into logistic regression.Results There were significant differences in MMSE and MoCA scores between the 4 groups (P＜0.05).Between the normal cognition and MCI groups,significant differences were found in proportion of smokers,blood glucose level and severity of stroke (P＜0.05).Logistic regression analysis showed that compared with the normal blood glucose group the incidence of MCI was 2.707-fold higher in the stringent goals group (OR=2.707,95％ CI:1.035～7.083,P=0.042),2.963-fold higher in the general goals group (OR=2.963,95％ CI:1.064～8.277,P=0.038) and 2.604-fold higher in the goals-not-met group (OR=2.604,95％ CI:1.269～5.341,P=0.009).Conclusions MCI is more likely to occur in acute phase in patients with diabetes and SAO stroke.The patients can benefit from joint managements of diabetes,stroke and cognitive dysfunction in clinical practice.

Objective　To investigate the imaging characteristics and main clinical manifestations of patients with respiratory and/or cardiac arrest after medullary infarction (MI).Methods　The study included patients with respiratory and/or cardiac arrest after MI,who were hospitalized in the Department of Neurology of Huanhu hospital between 2016 and 2021.The patients were divided into groups and analyzed according to the infarct location and infarct size shown by MRI-DWI,the degree of vascular stenosis shown by MRA and the main clinical manifestations.Results　The study enrolled a total of 28 patients, including 19 patients with lateral medullary infarction (LMI) and 9 patients with medial medullary infarction (MMI).For LMI patients,from head to tail,there were 4 cases with upper MI,11 cases with middle MI,and 4 cases with lower MI.On the axial plane,there were 4 cases in the middle,14 cases in the dorsal,and 1 case through the middle and dorsal.Among the 28 patients,50% were large area MI (DWI high signal≥1/3 of the total area of medulla oblongata) and medium area MI (1/4 of the total area of medulla oblongata≤DWI high signal<1/3 of the total area of medulla oblongata).Sixteen cases completed brain MRA examination,of which 12 cases were moderate and severe vascular stenosis.Among the 28 patients,16 cases were complicated with infarction in other parts,of which 9 cases were complicated with cerebellar infarction.The main clinical symptoms were dizziness and dysarthria.For the 19 LMI patients,dizziness was the main complaint in 16,dysarthria in 16,dysphagia in 10,limb weakness in 7.For the 9 MMI patients,dizziness was the main complaint in 6,dysarthria in 8,dysphagia in 3,limb weakness in 7.Conclusion　LMI is the main type of respiratory and/or cardiac arrest after MI,and it is more common in patients with dorsal medulla oblongata in the middle part.The proportion of patients with medium and large area MI is relatively high.Most patients have moderate and severe vascular stenosis and often complicated with cerebellar infarction.The main complaints were dizziness and dysarthria.LMI was more prone to dysphagia and MMI to limb weakness.