Autoimmune encephalitis(AE)generally refers to a group of encephalitides mediated by autoimmune mechanisms.The current treatment for AE relies on immunotherapy,typically following a stepwise escalation regimen.A minority of patients may still be refractory to treatment,thus posing a major clinical challenge.In the pathogenesis of AE,B cells play a role through antibody secretion and cytokine regulation,whereas T cells contribute by promoting B cell differentiation and mediating neuronal attack.In recent years,immunotherapies targeting different antigens have become a research focus and emerged as a new treatment option for AE patients.This article summarizes the mechanisms of action of different targeted drugs and the progress of their clinical application in AE,and provides an outlook on future research directions.

Autoimmune encephalitis(AE)generally refers to a group of encephalitides mediated by autoimmune mechanisms.The current treatment for AE relies on immunotherapy,typically following a stepwise escalation regimen.A minority of patients may still be refractory to treatment,thus posing a major clinical challenge.In the pathogenesis of AE,B cells play a role through antibody secretion and cytokine regulation,whereas T cells contribute by promoting B cell differentiation and mediating neuronal attack.In recent years,immunotherapies targeting different antigens have become a research focus and emerged as a new treatment option for AE patients.This article summarizes the mechanisms of action of different targeted drugs and the progress of their clinical application in AE,and provides an outlook on future research directions.

A case of paraneoplastic cerebellar ataxia syndrome caused by immune checkpoint inhibitors(ICI)was treated with ofatumumab(OFA).The patient is a 57-year-old male.He used"Camrelizumab"immunotherapy for his previous history of small cell lung cancer.The main reason was"walking unsteadily for more than one year and shaking his head involuntarily for more than one month".After admission,the head MRI,chest CT,electroencephalogram,lumbar puncture and other related examinations were improved.The antibody spectrum of paraneoplastic neurological syndrome was anti-GAD65 antibody IgG(+),and the case was then diagnosed as the immune checkpoint inhibitor-related paraneoplastic neurological syndromes(PNS)of nervous system.After OFA treatment(20 mg/time),the symptoms were obviously improved.This paper analyzes the clinical features and diagnosis and treatment approaches of this case,in order to improve clinicians'understanding of the disease and provide reference for clinical diagnosis and treatment of similar cases.

Anaerobic bacteria are commonly classified as a distinct group of microorganisms capable of proliferation solely in environments with reduced oxygen tension,and are incapable of growth on the surface of solid media containing atmospheric air(equivalent to 18％oxygen)and/or 10％carbon dioxide.These bacteria have the potential to infiltrate the central nervous system via adjacent infections in the head and neck region,hematogenous dissemination,or cranial-cerebral trauma,leading to localized purulent infections,such as intracranial abscesses,which include cerebral abscesses,epidural abscesses,and subdural abscesses.Although meningitis caused by anaerobic bacteria is relatively rare,it remains a significant clinical concern.The present study comprehensively discusses the surgical interventions for central nervous system infections due to anaerobic bacteria,as well as the strategic selection and utilization of antibiotics and alternative therapeutic modalities.

Autoimmune glial fibrillary acidic protein astropathy(GFAP-A)is an autoimmune inflammatory disease of the central nervous system,with a prevalence rate of 0.6 per 100,000.Its clinical manifestations include subacute meningitis,encephalitis,myelitis,or combinations thereof.Approximately 40%of patients exhibit symptoms and signs of prodromal infection such as fever and headache,while 30%may develop tumors.Currently,diagnosis primarily relies on the presence of GFAP-IgG in cerebrospinal fluid.Differential diagnosis must exclude conditions such as central nervous system vasculitis,inflammatory demyelinating diseases,lymphoma,glioma,and brain metastases,posing significant challenges in clinical practice.This paper summarizes the clinical manifestations,diagnosis,and treatment of GFAP-A to enhance understanding of the disease and prevent misdiagnosis.

Autoimmune glial fibrillary acidic protein astropathy(GFAP-A)is an autoimmune inflammatory disease of the central nervous system,with a prevalence rate of 0.6 per 100,000.Its clinical manifestations include subacute meningitis,encephalitis,myelitis,or combinations thereof.Approximately 40%of patients exhibit symptoms and signs of prodromal infection such as fever and headache,while 30%may develop tumors.Currently,diagnosis primarily relies on the presence of GFAP-IgG in cerebrospinal fluid.Differential diagnosis must exclude conditions such as central nervous system vasculitis,inflammatory demyelinating diseases,lymphoma,glioma,and brain metastases,posing significant challenges in clinical practice.This paper summarizes the clinical manifestations,diagnosis,and treatment of GFAP-A to enhance understanding of the disease and prevent misdiagnosis.

Anaerobic bacteria are commonly classified as a distinct group of microorganisms capable of proliferation solely in environments with reduced oxygen tension,and are incapable of growth on the surface of solid media containing atmospheric air(equivalent to 18％oxygen)and/or 10％carbon dioxide.These bacteria have the potential to infiltrate the central nervous system via adjacent infections in the head and neck region,hematogenous dissemination,or cranial-cerebral trauma,leading to localized purulent infections,such as intracranial abscesses,which include cerebral abscesses,epidural abscesses,and subdural abscesses.Although meningitis caused by anaerobic bacteria is relatively rare,it remains a significant clinical concern.The present study comprehensively discusses the surgical interventions for central nervous system infections due to anaerobic bacteria,as well as the strategic selection and utilization of antibiotics and alternative therapeutic modalities.