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  • Autoimmune Encephalitis Section
    AN Lili, HE Zhiyi
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 483-486. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0091

    Autoimmune encephalitis(AE)is a type of brain inflammation caused by the immune system mistaking autoantigens expressed in the central nervous system for foreign antigens,thereby resulting in abnormal immune response that affects brain parenchyma(cortex or deep gray matter and white matter)and may involve the meninges and spinal cord. This disease is not an infectious inflammatory disease caused by pathogen invasion and is fundamentally different from purulent encephalitis and viral encephalitis,and it can occur in different populations such as children,adolescents,and adults. A recent epidemiological study from the United States shows that there might be a higher prevalence rate of AE,and the prevalence rate of AE was 13.7/100 000 in this population-based study,with no significant difference from the prevalence rate of infectious encephalitis. Since the discovery of anti-N-methyl-D-aspartate(NMDA)receptor antibodies,many patients who experience mental symptoms with rapid progression,abnormal behavior,seizures,or unexplained coma have been diagnosed with AE. The onset of symptoms is usually unclear,which might be similar to mental illness,but then the disease often progresses rapidly and causes damage to brain parenchyma and even loss of consciousness and coma,which usually requires intensive care. Therefore,a comprehensive and systematic understanding of AE is of great significance for clinicians to achieve early identification,diagnosis,and treatment and help patients obtain a good prognosis. This article aims to provide a comprehensive overview of existing research findings of AE in terms of its past,present,and future development and from cognitive limitations to the leap towards precision treatment,in order to provide assistance for diagnosis and treatment among clinicians.

  • Autoimmune Encephalitis Section
    WEI Quanfeng, ZHAO Yinan
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 487-490. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0092

    Autoimmune encephalitis(AE)is a heterogeneous disorder caused by immune-mediated attack on the central nervous system,and it is characterized by complex clinical manifestations and insufficient diagnostic specificity,which often leads to misdiagnosis and delayed treatment. By integrating expertise from various specialties such as neurology,critical care medicine,psychiatry,and oncology,multidisciplinary treatment(MDT)can provide individualized diagnosis and treatment regimens for AE patients,with significant advantages in patients comorbid with tumor,autonomic dysfunction,or severe complications. This article elaborates on the theoretical rationale for implementing MDT in AE management,the methods for individualized treatment,and existing challenges in clinical practice,in order to provide a reference for optimizing clinical management strategies for AE and promoting the development of precision diagnosis and treatment for complex nervous system diseases.

  • Autoimmune Encephalitis Section
    XIAO Yuxiu, WANG Baojie, GUO Shougang
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 491-497. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0093

    Autoimmune encephalitis(AE)is a group of inflammatory disorders within the central nervous system(CNS)triggered by autoimmune mechanisms. Most AE patients show good responses to first-line immunotherapies such as corticosteroids and intravenously injected immunoglobulin. Nevertheless,the adverse effects associated with extensive immunosuppression have become a difficult issue in treatment,and some patients with severe conditions or recurrence still require further intensive therapy. Therefore,it is urgently needed to search for novel treatment strategies with high efficiency,precision,and safety. In recent years,targeted immunotherapy and chimeric antigen receptor T-cell immunotherapy that specifically target immune cells or cytokines involved in the pathogenesis of AE have gradually become research hotspots,with good tolerability and safety,which provides new options for the clinical management of AE.

  • Autoimmune Encephalitis Section
    JIA Yan, GUO Jun
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 498-500. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0094

    Autoimmune encephalitis(AE)refers broadly to a group of encephalitic disorders mediated by autoimmune mechanisms. AE is characterized by complex pathogeneses and diverse clinical manifestations,and there are still numerous challenges in the diagnosis and treatment of AE. With the development of frontier technologies such as vaccines,gene editing,and big data,new opportunities have emerged for transforming the diagnosis and treatment strategies for AE. Vaccines play a dual role in AE: on the one hand,they can prevent infections; on the other hand,they may trigger autoimmune responses through molecular mimicry. Emerging nanovaccine technologies are expected to achieve safer and more effective immunomodulation. Gene editing techniques,especially the CRISPR-Cas9 system,have shown potential in targeted regulation of the function of immune cells and repair of nervous tissue,which provides new pathways for precise intervention in the treatment of AE. The application of big data technologies,including artificial intelligence,natural language processing,and deep learning,has promoted the early diagnosis of AE and the development of individualized treatment regimens. This article reviews the research advances and clinical prospects of these cutting-edge technologies in AE,in order to provide insights and references for the development of precision medicine,interdisciplinary collaboration,and future treatment strategies for AE.

  • Autoimmune Encephalitis Section
    YU Lei, LI Hang, WEN Yao
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 501-508. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0095

    Autoimmune encephalitis(AE)is a group of antibody-mediated inflammatory disorders that target neuronal antigens,with the main symptoms of mental and behavioral disorders,epilepsy,and cognitive impairment. In recent years,specific antibodies,such as anti-NMDAR antibody and anti-LGI1 antibody,have played an important role in the pathogenesis of AE and have become effective biomarkers,which have significantly improved the early detection rate of AE. As novel antibodies continue to be discovered,the pathological mechanisms of AE are constantly clarified,providing new directions for precision treatment. Nevertheless,there are still challenges in the mechanism of action and clinical application of these emerging antibodies,requiring support from more basic studies and clinical data. This article discusses the role of antibodies in AE,analyzes the types of newly discovered antibodies and their role in disease progression,and explores the potential and challenges of antibodies used as tools for precise diagnosis and targeted therapy.

  • Autoimmune Encephalitis Section
    CHANG Yuanmin, SUN Yue, CAO Shugang
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 509-511. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0096

    This article reports the clinical features and prognosis of a patient with anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis comorbid with novel coronavirus infection. After anti-NMDAR encephalitis is comorbid with SARS-CoV-2 infection,the symptoms may worsen,and timely immunoadsorption and second-line immunotherapy can help with disease recovery.

  • Autoimmune Encephalitis Section
    LI Yongfang, CHANG Jie, TANG Yi
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 512-516. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0097

    Objective To investigate the clinical manifestations and prognosis of patients with anti-leucine rich glioma inactivated 1(LGI1)antibody encephalitis. Methods A retrospective analysis was performed for the data of patients with anti-LGI1 antibody encephalitis who were hospitalized in Department of Neurology,Xuanwu Hospital,Capital Medical University,from September 2019 to December 2023,including clinical features,treatment,and prognosis. Results A total of 80 patients were enrolled,including 48 male patients and 32 female patients. Of all 80 patients,51(63.8%)had the initial symptom of epilepsy,13(16.3%)had the initial symptom of faciobrachial dystonic seizures,26(32.5%)had the initial symptom of cognitive impairment,and 12(15%)had the initial symptom of mental and behavioral disorders. As for comorbidities,there were 28 patients(35%)with hyponatremia,22(27.5%)with Hashimoto's thyroiditis,and 5(6.25%)with tumor. All 80 patients tested positive for serum LGI1 antibody,and 69(86.3%)tested positive for LGI1 antibody in cerebrospinal fluid. Among the 80 patients,37(46.25%)had abnormalities on magnetic resonance imaging,and 30 had abnormalities on 18F-FDG PET/CT. There were 50 patients with abnormalities on video electroencephalography. A total of 77 patients received first-line immunotherapy,and after follow-up for 1 year,19.4% of the patients had the sequela of seizure,59.7% of the patients had deterioration of the memory,and 48.6% of the patients had mental and behavioral disorders. Conclusion Epilepsy,cognitive impairment,and mental and behavior disorders are the most common manifestations of anti-LGI1 antibody encephalitis. There is generally a good prognosis after immunotherapy,with the sequelae of cognitive impairment and mental and behavioral disorders.

  • Autoimmune Encephalitis Section
    CHEN Lin, BAI Xinping, WANG Youmeng
    Journal of Apoplexy and Nervous Diseases. 2025, 42(6): 517-522. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0098

    Objective To investigate the clinical features,laboratory findings,and prognosis of patients with autoimmune encephalitis positive for leucine rich glioma inactivated 1(LGI1)antibody. Methods We reviewed the clinical data of 11 patients with anti-LGI1 encephalitis hospitalized in Fu Yang People's Hospital from October 2019 to December 2024. Results All the 11 patients(100%)had cognitive function involvement,9(81.8%)had epileptic seizures,5(45.5%)had mental and behavioral abnormalities,4(36.4%)had sleep disorders,3(27.3%)had autonomic nervous dysfunction,2(18.2%)had faciobrachial dystonic seizures(FBDS),2(18.2%)had facial numbness,and 1(9.1%)had phantosmia and pruritus in both eyes and the neck. LGI1 antibody was positive in the serum of all the cases(100%)and present in the cerebrospinal fluid of 8 cases(72.3%). Seven cases(63.6%)had hyponatremia,and 5 cases(45.5%)also had hypophosphatemia,hypocalcemia,and hypomagnesemia in addition to blood sodium lower than 134 mmol/L. Intracranial abnormalities were detected in 7 cases(63.6%)on magnetic resonance imaging. Electroencephalogram abnormalities were recorded in 6 cases(54.5%). After immunosuppressive treatment,2 cases(18.2%)had recurrent symptoms,and 2 cases(18.2%)had residual mild memory impairment. In terms of prognosis,the modified Rankin Scale scores were generally favorable. Conclusion Anti-LGI1 encephalitis manifests as convulsions,FBDS,memory decline,mental and behavioral abnormalities,autonomic nervous dysfunction,sleep disorders,hyponatremia,and multiple electrolyte disorders such as hypomagnesemia,hypocalcemia,and hypophosphatemia when blood sodium is below 134 mmol/L. The prognosis with immunosuppressive treatment is favorable,but recurrent symptoms may occur.

  • Treatable Skeletal Muscle Disorders Section
    ZHAO Bing, YAN Chuanzhu
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 387-394. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0075

    Autoimmune myositis (AIM) is a group of autoimmune diseases that primarily affect muscle fibers, often accompanied by the involvement of multiple organs such as the skin,lungs,and joints.It is the most common treatable skeletal muscle disease in adults. Although most patients with AIM can achieve remission with traditional immunosuppressive therapies, their quality of life can be heavily reduced due to drug-related adverse effects and the high relapse rate and high disability rate of the disease. With the deepening understanding of the immunopathological mechanisms of AIM,various biologics targeting different components of these mechanisms have brought new hope for patients with AIM. This article reviews the advances in the treatment of AIM.

  • Treatable Skeletal Muscle Disorders Section
    ZHAO Yuying, YAN Chuanzhu
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 395-400. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0076

    Glycogen storage disease type Ⅱ (GSD Ⅱ), also known as Pompe disease, is a common autosomal recessive lysosomal storage disease with predominantly muscle tissue involvement, and it is caused by defects in the GAA gene which encode acid α-D-glucosidase in lysosomes. According to the age of onset and the main organs involved, it is classified into infant-onset Pompe disease (IOPD) and late-onset Pompe disease(LOPD). The diagnosis of this disease depends on the reduction in GAA enzyme activity, the detection of GAA gene mutations, and muscle tissue biopsy, and early diagnosis and treatment are crucial for prognosis. Recombinant human GAA(rhGAA) enzyme replacement therapy prepared by the gene recombination technology is currently the main disease-modifying treatment method for Pompe disease, among which the earliest drug alglucosidase α has shown good efficacy in improving muscle strength and respiratory function and prolonging survival time, and the new-generation rhGAA drugs avalglucosidase α and cipaglucosidase alfa provide new options, especially for patients with poor outcomes and severe symptoms. Substrate ablation therapy and gene therapy are still under exploration, and disease-modifying therapies combined with nutritional and exercise therapies and multidisciplinary long-term management will achieve twice the result with half the effort.

  • Treatable Skeletal Muscle Disorders Section
    KE Qing
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 401-408. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0077

    Hereditary skeletal muscle ion channelopathies are a group of heterogeneous hereditary diseases caused by mutations in the skeletal muscle ion channel genes.According to clinical manifestations, hereditary skeletal muscle channelopathies are classified into two major categories:non-dystrophic myotonia and periodic paralysis. Non-dystrophic myotonia includes myotonia congenita, paramyotonia congenita, and sodium channel myotonia. Periodic paralysis includes hypokalemic type, normal serum potassium type, hyperkalemic type, and Andersen-Tawil syndrome. Because of an overlap between non-dystrophic myotonia and periodic paralysis in clinical phenotype and molecular mechanism, a few patients can simultaneously exhibit the phenotypes of both conditions, indicating that hereditary skeletal muscle channelopathies are a continuity in the clinical spectrum. This article reviews the classifications, clinical manifestations, diagnostic criteria, genetic pathological types, pathogenic mechanisms, and treatment approaches and progress of hereditary skeletal muscle ion channelopathies.

  • Treatable Skeletal Muscle Disorders Section
    ZHAO Bing, YAN Chuanzhu
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 409-413. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0078

    Sporadic late-onset nemaline myopathy (SLONM) is a rare, acquired, and treatable myopathy with a subacute or chronic progressive clinical course, characterized by asymmetric muscle atrophy and weakness in the axial and limb muscles, with or without involvement of respiratory and cardiac muscles. The only definitive diagnostic method at present is the identification of rods accumulation in muscle fibers by muscle biopsy pathology. This article provides a review of the clinical manifestations, diagnostic evaluations, muscle pathology, and advances in the treatment of SLONM.

  • Treatable Skeletal Muscle Disorders Section
    DAI Yi
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 414-418. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0079

    Duchenne muscular dystrophy is the most common genetic neuromuscular disease and is also a severely disabling and fatal disease that seriously harms the health of children. Treatment regimens are rapidly advancing with a gradually deeper understanding of the disease. This article introduces the etiology, pathogenesis, clinical manifestations, auxiliary examinations, diagnosis, and differential diagnosis of the disease, with a focus on the advances in the treatment of Duchenne muscular dystrophy in recent years, in order to enhance the management skills of neurologists, pediatricians, and other related specialists.

  • Treatable Skeletal Muscle Disorders Section
    WEN Bing, YAN Chuanzhu
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 419-426. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0080

    Lipid storage myopathy (LSM) is a lipid metabolic disorder characterized by excessive lipid droplet accumulation in muscle fibers. Classic multiple Acyl-CoA dehydrogenase deficiency (MADD), also known as glutaric aciduria type Ⅱ, is a disease with various clinical manifestations caused by mutations in electron transfer flavoprotein (ETF) and ETF-ubiquinone oxidoreductase. In recent years, a large amount of evidence has shown that classic late-onset MADD caused by mutations in the electron transfer flavoprotein dehydrogenase gene is the main cause of LSM. Besides classic MADD, many other diseases with similar changes in blood acylcarnitines and urinary organic acids can also cause LSM, and such diseases are call MADD-like disorders or MADD spectrum. This article reviews the clinical, pathological, biochemical, and molecular features of LSM with various etiologies and the latest advances in treatment, with a focus on the latest findings associated with MADD spectrum.

  • Treatable Skeletal Muscle Disorders Section
    WANG Jiayin, ZHUANG Xingyu, WANG Jianing
    Journal of Apoplexy and Nervous Diseases. 2025, 42(5): 427-433. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0081

    Mitochondrial diseases are a group of hereditary disorders characterized by impaired oxidative phosphorylation in the mitochondrial respiratory chain caused by defects in either mitochondrial DNA or nuclear DNA, and such diseases have complex and diverse clinical manifestations and often involve multiple organs and systems, with the main manifestation of lesions in the nervous system and muscles due to their high energy demands. At present, there is still a lack of effective therapies for most mitochondrial diseases, and therefore, multidisciplinary management is essential in clinical practice, integrating various therapeutic approaches to provide personalized treatment regimens for patients with mitochondrial diseases. The primary treatment principle involves the timely correction of pathological and physiological abnormalities through pharmacological interventions, dietary modifications, and exercise management, along with the prompt treatment of system-specific impairments and the prevention of potential complications.

  • Movement Disorders Section
    WANG Xue, WANG Xuemei
    Journal of Apoplexy and Nervous Diseases. 2025, 42(4): 291-296. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0058

    Orthostatic hypotension (OH) is the main symptom of cardiovascular autonomic dysfunction in the elderly population,which often manifests as orthostatic dizziness,syncope,and traumatic falls. OH often has a poor prognosis and is one of the causes of cognitive impairment in the elderly,and therefore,it is important to explore the pathogenesis of OH and related interventions. The vestibular system participates in orthostatic blood pressure regulation through vestibular sympathetic reflex,and dysfunction of the vestibular system can lead to the dysfunction of orthostatic blood pressure regulation,which further leads to OH. Previous studies have shown that galvanic vestibular stimulation (GVS) can regulate the function of the cardiovascular system,and different stimulation parameters have different target effects on blood pressure. This article summarizes the role of vestibular system and GVS in orthostatic blood pressure regulation,in order to provide a reference for the future research on the application of GVS in the treatment of OH.

  • Movement Disorders Section
    LI Yang, WAN Xinhua
    Journal of Apoplexy and Nervous Diseases. 2025, 42(4): 297-299. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0059

    This study reports a pair of sisters with generalized dystonia and 3-methylglutaconic aciduria,including clinical phenotype analysis and genetic testing. Through medical history collection,imaging and laboratory examinations,and genetic analysis,it was found that the two patients had a homozygous mutation,c.1687T>C,in the Serac1 gene on chromosome 6,which was located at exon 16. The Serac1 gene mutation with adolescent-onset generalized dystonia as the main clinical phenotype has not been reported in the literature before. This study finds for the first time that Serac1 mutation at this site can cause generalized dystonia,which can provide a reference for the diagnosis and treatment of similar cases in the future.

  • Movement Disorders Section
    LIU Chenchen, GAO Yang, WANG Wei
    Journal of Apoplexy and Nervous Diseases. 2025, 42(4): 300-305. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0060

    Objective To investigate the clinical and radiological features of patients with different phenotypes of multiple system atrophy (MSA). Methods A total of 400 patients with MSA who attended the outpatient service or were hospitalized in Department of Neurology,Chinese PLA General Hospital,were enrolled,among whom there were 294 patients with MSA-cerebellar type (MSA-C) and 106 patients with MSA-Parkinsonian type (MSA-P). The t-test and the chi-square test were used to analyze the clinical manifestations,radiological features,and blood biochemical indicators of the two groups. Results As for clinical manifestations,there were significant differences in cerebellar symptoms,constipation,and Babinski sign between MSA-C patients and MSA-P patients (P<0.05). As for radiological features,positron emission tomography/computed tomography (PET/CT) showed that MSA-P patients had a typical reduction in DAT uptake in the putamen and the caudate nucleus,while magnetic resonance imaging showed that compared with the MSA-C group,the MSA-P group had a significantly higher proportion of patients with putamen fissure sign or white matter demyelination; for MSA-C patients,PET/CT showed cerebellar hypometabolism,and magnetic resonance imaging showed the cross sign and high signal intensity in the pontine arm,as well as a significantly higher proportion of patients cerebellar and pontine atrophy than MSA-P patients (P<0.05). As for laboratory markers,MSA-P patients had a significantly lower level of uric acid than MSA-C patients (P=0.029). Conclusion Patients with different subtypes of MSA have specific clinical features,radiological features,and uric acid level,which has a certain significance in the accurate diagnosis of MSA.

  • Movement Disorders Section
    CHEN Xuejiao, XING Xiuying, LIU Bin
    Journal of Apoplexy and Nervous Diseases. 2025, 42(4): 306-309. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0061

    Objective To investigate the features of non-motor symptoms and transcranial substantia nigra ultrasound in essential tremor (ET). Methods General data were collected from 50 patients with ET and 50 healthy controls,and non-motor symptom scales and transcranial nigra sonography (TCS) were used for assessment. The t-test,the non-parametric test,and the chi-square test were used for comparison of general data,scale assessment results,and TCS findings between the two groups. Results There were significant differences between the ET group and the healthy control group in the total scores of NMSS,MoCA,HAMA,HAMD,PSQI,ESS,and FSS and the incidence rates of cognitive impairment,moderate or severe anxiety,poor sleep,and daytime sleepiness,while there were no significant differences in the incidence rates of moderate or severe depression and fatigue between the two groups. There were no significant differences between the two groups in terms of “hyperechoic area of the left side” “hyperechoic area of the right side” “hyperechoic area of both sides” “S/M value” “the number of cases with a hyperechoic area of >0.2 cm2 for at least one side” “the number of cases with an S/M ratio of >7%” and “the number of cases with positive TCS results”. Conclusion Compared with healthy controls,ET patients are more susceptible to cognitive impairment,anxiety,depression,poor sleep quality,daytime sleepiness,and fatigue,and the non-motor symptoms of ET should be taken seriously in clinical practice. TCS examination has a relatively low diagnostic value in ET patients and healthy individuals.

  • Movement Disorders Section
    SU Beiqing, LI Yaoyao, LIU Ya
    Journal of Apoplexy and Nervous Diseases. 2025, 42(4): 310-315. https://doi.org/10.19845/j.cnki.zfysjjbzz.2025.0062

    Objective To investigate the cause,pathogenesis,clinical manifestations,treatment,and prognosis of secondary hemichorea based on related clinical features and examinations by summarizing the medical records of 25 patients with secondary hemichorea-hemiballism. Methods An analysis was performed for 25 patients with hemichorea-hemiballism who were admitted and treated from July 2018 to April 2024,including general status,clinical features,laboratory examinations,MRI or CT examination,treatment methods,and prognosis. Results Of all 25 patients,11 (44.0%) had acute cerebrovascular diseases [including 7 cases (28.0%) of cerebral infarction,3 cases (12.0%) of cerebral hemorrhage,and 1 case (4.0%) of moyamoya disease],13 (44.0%) had hyperglycemia,and 1 had unknown causes. Of all 25 patients with hemichorea-hemiballism after treatment of the primary disease and symptomatic treatment,18 patients had significant improvements in hemichorea symptoms,and 7 had disappearance of hemichorea symptoms. One patient experienced recurrence after half a year due to self-withdrawal of medication,and the other patients took medication regularly,with no recurrence at follow-up half a year later.Conclusion Hemichorea-hemiballism is more common in the elderly,and acute cerebrovascular disease is the most common cause of hemichorea-hemiballism,followed by hyperglycemia,with the basal ganglia as the main lesion site. In addition to the treatment of the primary disease,symptomatic treatment with haloperidol,clonazepam,or risperidone can significantly improve clinical symptoms and help to achieve a good prognosis.