CNS Infectious Diseases 1 meningitis aseptic meningitis bacterial
中樞神經系統感染性疾病 (CNS Infectious Diseases) 1. 腦膜炎(meningitis) 無菌性腦膜炎(aseptic meningitis) 細菌性腦膜炎(bacterial meningitis) 結核性腦膜炎(tuberculous meningitis) 隱球菌腦膜炎(cryptococcal meningitis) 2. 腦炎(encephalitis) 日本腦炎(Japanese encephalitis) 疱疹性腦炎(herpes simplex encephalitis) 腸病毒腦炎(enterovirus encephalitis)
types
Antibiotics for bacterial meningitis H. influenzae S. pneumoniae N. meningitidis Staphylo. ampicillin ceftriaxone cefotaxime G(-)baccilla ampicillin penicillin G oxacillin cefotaxime penicillin G ampicillin cephalothin ceftazidine cefotaxime cefuroxime ceftriaxone vancomycin aminoglyco. vancomycin
HIB Meningitis Extra-axial fluid Echogenic sulci Subdural empyema
Salmonella meningitis progressive hydrocephalus 2 D 11 D 19 D 25 D (Hung KL: Brain & Dev 8: 31 -6, 1986)
Brain abscess in CHD 12 y/o girl under surgical tx Onset 1 d 2 w 1. 5 m
TB meningitis gross pathology: basal meningitis micro-findings: Langerhans giant cell & MNC infiltration
Cryptococcus in CSF (Indian stain)
17 y/o M JBE
HSV encephalitis 2 y/o female 7 m/o male
EV 71 endemic infections in Taiwan n Epidemic outbreak of EV 71 infection: (Taiwan, 1998) 129, 106 cases reported 405 (0. 3%) cases with severe complications: encephalitis, aseptic meningitis, flaccid paralysis, myocarditis, pulmonary edema/hemorrhage 78 cases expired
EV 71 encephalitis & myocarditis 7 m/o, male S/S’: high fever, multiple oral ulcers, Rt arm weakness P. E. : stupor, cyanosis, tachypnea, tachycardia, R’t side upper limb flaccid paralysis and absent DTR CSF: cc 380 (P/M=4/6), protein 113, glucose 118 mg/d. L Rectal swab culture: EV 71; sonogram: dilated cardiomyopathy 10/13 9: 55 PM 10/14 2: 10 AM
癲癇之分類 (國際抗癲癇聯盟, 1981) I. 部份性發作: 單純部份性發作 複雜部份性發作 次發性汎發性發作 II. 汎發性發作: 失神發作 強直陣攣型發作 肌躍性發作 陣攣型發作 強直型發作 失張力性發作 III. 未歸類: Partial seizure Simple partial seizure Complex partial seizure Secondary generalized seizure Generalized seizure Absence seizure Tonic-clonic seizure Myoclonic seizure Clonic seizure Tonic seizure Atonic seizure Unclassified epileptic seizure
Neural tube formation
移行期障礙 Lissencephaly -- 平腦症 1. 5 y/o male
神經肌肉疾病(Neuromuscular Diseases) 1. 脊髓運動細胞疾病 2. 3. 4. (Spinal motor neuron disease) 末梢神經病變 (Peripheral Neuropathy) 神經肌肉傳導障礙 (Neuromuscular junction) 肌肉病變 (Muscle disease)
Spinal Muscular Atrophy (SMA) 脊髓神經肌肉萎縮症 HE stain ATPase p. H 9. 4
Duchenne Muscular Dystrophy 裘馨氏肌肉失養症 Calf pseudohypertrophy Gower's sign
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