Vertigo, a common clinical complaint, is closely linked with neurologic diseases. This article summarizes many neurologic diseases (including stroke, migraine, epileptic vertigo, psychiatric abnormalities, rotational vertebrobasilar insufficiency, and multiple sclerosis) with vertigo as one of its main symptoms, and introduces the diagnostic methods of vertigo.
Central Nervous System Diseases ; diagnosis ; Humans ; Vertigo ; diagnosis

An increasing number of neuronal autoantibodies which target cell surface or synaptic proteins have been discovered over the last decade. Autoimmune encephalitis refers to this new category of autoimmune-mediated neurological disorders, which involve the central nervous system. Recent studies have established that autoimmune encephalitis is now the major cause of encephalitis, which was previously considered to be encephalitis of an unknown etiology. Moreover, the fact that autoimmune encephalitis is potentially treatable with immunomodulating therapy has changed the paradigm for the diagnosis and treatment of acute encephalitis syndrome. We herein review the pathophysiology, clinical manifestations, diagnosis, and treatment of autoimmune encephalitis with a focus on corticosteroid therapy as the first-line immunotherapy. In addition, regarding the diagnostic approach, we emphasize the differentiation between autoimmune and infectious encephalitis, because this distinction is not necessarily clear-cut in real clinical practice and should be considered when determining the initiation and type of immunotherapy.
Autoantibodies ; Autoimmune Diseases of the Nervous System ; Central Nervous System ; Diagnosis ; Encephalitis ; Glucocorticoids ; Immunotherapy ; Infectious Encephalitis ; Nervous System Diseases ; Neurons

Neurilemmomatosis is a clinical entity consisting of multiple cutaneous neurilemmomas, central nervous system tumors, and neurologic disorders. Since Shishiba et al first described the disorder in 1984, several cases have been reported. We report a Korean case of neurilemmomatosis showing multiple neurilemmomas of the skin and spinal cord, with associated motor and sonsory nerve disturbance. Histologic, immunohistopathologic and electron microscopic studies confirmed the diagnosis.
Central Nervous System Neoplasms ; Diagnosis ; Nervous System Diseases ; Neurilemmoma ; Skin ; Spinal Cord

OBJECTIVE: To assess the value of chromosomal microarray analysis (CMA) for the diagnosis of fetuses with anomalies of the central nervous system (CNS) and summarize the outcome of the pregnancies and follow-up. METHODS: A total of 636 fetuses from June 2014 to December 2020 who were referred to the Prenatal Diagnosis Center of Nanjing Drum Tower Hospital due to abnormal CNS prompted by ultrasound were selected as the research subjects. Based on the ultrasound findings, the fetuses were divided into ventricular dilatation group (n = 441), choroid plexus cyst group (n = 41), enlarged posterior fossa group (n = 42), holoprosencephaly group (n = 15), corpus callosum hypoplasia group (n = 22), and other anomaly group (n = 75). Meanwhile, they were also divided into isolated (n = 504) and non-isolated (n = 132) groups based on the presence of additional abnormalities. Prenatal samples (amniotic fluid/chorionic villi/umbilical cord blood) or abortus tissue were collected for the extraction of genomic DNA and CMA assay. Outcome of the pregnancies and postnatal follow-up were summarized and subjected to statistical analysis. RESULTS: In total 636 fetuses with CNS anomalies (including 89 abortus tissues) were included, and 547 cases were followed up. The overall detection rate of CMA was 11.48% (73/636). The detection rates for the holoprosencephaly group, ACC group, choroid plexus cyst group, enlarged posterior fossa group, ventricular dilatation group and other anomaly group were 80% (12/15), 31.82% (7/22), 19.51% (8/41), 14.29% (6/42), 7.48% (33/441) and 9.33% (7/75), respectively. Compared with the isolated CNS anomaly group, the detection rate for the non-isolated CNS anomaly group was significantly higher (6.35% vs. 31.06%) (32/504 vs. 41/132) (χ² = 62.867, P < 0.001). Follow up showed that, for 52 fetuses with abnormal CMA results, 51 couples have opted induced labor, whilst 1 was delivered at full term with normal growth and development. Of the 434 fetuses with normal CMA results, 377 were delivered at full term (6 had developmental delay), and 57 couples had opted induced labor. The rate of adverse pregnancy outcome for non-isolated CNS abnormal fetuses was significantly higher than that of isolated CNS abnormal fetuses (26.56% vs. 10.54%) (17/64 vs. 39/370) (χ² = 12.463, P < 0.001). CONCLUSION Fetuses with CNS anomaly should be tested with CMA to determine the genetic cause. Most fetuses with negative CMA result have a good prognosis, but there is still a possibility for a abnormal neurological phenotype. Fetuses with CNS abnormalities in conjunct with other structural abnormalities are at increased risk for adverse pregnancy outcomes.
Female ; Pregnancy ; Humans ; Holoprosencephaly ; Prenatal Diagnosis/methods* ; Central Nervous System ; Fetus/abnormalities* ; Nervous System Malformations/genetics* ; Microarray Analysis ; Central Nervous System Diseases ; Cysts ; Chromosome Aberrations ; Ultrasonography, Prenatal/methods*

Leprosy is chronic infectious disease caused by Mycobacterium leprae, a microorganism to which only a small portion of any given population is susceptible. Although M. leprae can be found nearly anywhere in the body outside the central nervous system, even in the more severe types of leprosy it produces significant damage only in the superficial nerves, the skin, the anterior third of eye, the upper respiratory tract, and testis. Bacillary invasion of peripheral nerve commonly occur in leprosy patients and lepromatous neuropathy is treatable neuropathy in the world. So early detection of lepromatous neuropathy is important for social adaptation and prevention of life threatening complications. For differential diagnosis with other peripheral neuropathies, general overviews of peripheral neuropathies about anatomical, clinical, laboratory and diagnostic aspects of peripheral nervous system.
Central Nervous System ; Communicable Diseases ; Diagnosis, Differential ; Humans ; Leprosy ; Mycobacterium leprae ; Peripheral Nerves ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Respiratory System ; Skin ; Testis

Lymphomatosis cerebri is considered a diffuse form of primary central nervous system lymphoma and very rare. It is not well recognized and may be misdiagnosed with infiltrating tumors, degenerative disorders, ischemic diseases, and infectious diseases developed in the brain. Awareness of the possibility of this rare disease and early biopsy are required for differential diagnosis and preventing poor clinical outcomes. We report a case with lymphomatosis cerebri who presented with rapid neurological deteriorations and review the relevant literatures.
Biopsy ; Brain ; Central Nervous System ; Communicable Diseases ; Diagnosis, Differential ; Lymphoma ; Rare Diseases

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system that leads to neurological disability. The diagnosis of MS relies on the MRI criteria, which can demonstrate dissemination in space and time. Exclusion of other demyelinating mimics is essential because there are no specific biomarker for MS and MRI criteria are still have imperfect. There is incremental improvements in MS treatment option that have contributed to the delay of disease progression. The early initiation of DMT may ameliorate the neurological disability. In this review, we discusses the new diagnostic MS criteria and summarize the evidences supporting the early treatment in the course of MS.
Central Nervous System ; Demyelinating Diseases ; Diagnosis ; Disease Progression ; Early Diagnosis* ; Magnetic Resonance Imaging ; Multiple Sclerosis*

Adult ; Central Nervous System Diseases ; diagnosis ; surgery ; Hamartoma ; diagnosis ; surgery ; Humans ; Male

Central Nervous System Diseases ; diagnosis ; therapy ; Humans ; Practice Guidelines as Topic ; Puberty, Precocious ; diagnosis ; therapy

OBJECTIVES: Aspergillosis of central nervous system(CNS) is a rare pathologic condition and it has been known to be difficult to diagnose and treat. We analyzed seven cases of central nervous system aspergillosis. The clinical characteristics, and the problems in diagnosis and treatment are discussed with review of previous literatures. MATERIALS AND METHODS: We reviewed the clinical records, radiological findings, and pathologic reports of 7 patients with aspergillosis which involved CNS. RESULTS: Five patients were immunocompetent, and infection was related with previous operation in 4 of them. Two patients were immunocompromised and had no history of operation. Five patients had intracranial lesions and two had spinal lesions. Mean duration from the onset of initial symptom to pathologic diagnosis was 2.4 months. Mean duration from the previous operation to the onset of symptom was 9.3 months, and from the onset of symptom to diagnosis was 2.9 months in the patients who had histories of operation. All of them were treated with surgical procedures and intravenous and oral antifungal agents, resulting in cure in 6 cases. Mean duration of the treatment was 4.9 months. CONCLUSION: Because aspergillosis of CNS is a rare disease and is difficult to be differentiated from the pyogenic abscess or recurrent tumor, the pathologic diagnosis is very important for adequate treatment. Although the prognosis of aspergillosis of CNS has been known to be poor, adequate surgery for both diagnosis and treatment and antifungal chemotherapy resulted in good outcome.
Abscess ; Antifungal Agents ; Aspergillosis* ; Central Nervous System* ; Diagnosis ; Drug Therapy ; Humans ; Prognosis ; Rare Diseases