Attached: Detailed examination information of 21 patients
| Patients | Clinical manifestations | Positive signs of nervous system | Involved nervous system | Affected cranial nerves | Imaging examination | Cerebrospinal fluid (CSF) | Blood/CSF culture | Serum agglutination test (SAT) | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pressure (mmH2O) | WBC (×106/L) | Protein (mg/dl) | Chlorine (mmol/L) | IgG (mg/dl) | CSF/serum glucose (%) | ||||||||
| 1 | Fever, fatigue, hearing loss, weakness of both lower limbs and urination and defecation function disturbance | Paralysis of limbs, positive pathological signs and abnormal sensation | Demyelination, spinal cord damage | 8 | Head MRI showed abnormal signals in the white matter around the anterior horn of the lateral ventricle on both sides. Cervical spinal cord MRI showed cervical 2-4-disc degeneration and cervical 3-5-disc herniation. | 150 | 40 | 130 | 107 | 26.20 | 26 | —— | Positive |
| 2 | Fever, hearing loss | Positive pathological signs and abnormal sensation | Meningitis, encephalitis | 8 |
No significant abnormalities were found in cervical and thoracic pulps. Head MRI showed abnormal white matter signals in the left temporal and parietal cortex. T2, Flair, DWI showed high signals. |
210 | 76 | 136 | 104 | 35.30 | 25 | —— | Positive |
| 3 | Fever, headache, trance | Abnormal mental behavior | Meningitis, encephalitis | - | MRI of the head showed abnormal signals in the left frontal convex surface and right lateral fissure with bilateral temporal lobe meningeal enhancement. | 180 | 599 | 301 | 104 | 155.00 | 36 | —— | Positive |
| 4 | Fatigue, hearing loss, spastic paralysis of both lower limbs | Positive pathological signs, ataxia | Demyelination, spinal cord damage | 8 | MRI of the head showed abnormal signal under the cortex of the left frontal parietal lobe and the right parietal lobe. Considering the possibility of demyelination, there was a small amount of subdural effusion in both the frontal and left temporal parts. | 140 | 78 | 240 | 108 | 66.40 | 19 | —— | Positive |
| 5 | Blurred vision | Eye movement disorder | Meningitis, encephalitis, central demyelination | 2 | MRI of the head showed obvious enhancement of meninges on the left side of clivus, bilateral forehead, and anterior skull base, and abnormal enhancement shadows in bilateral optic nerve sheath, left hypoglossal nerve and jugular fossa, so it is possible to consider inflammatory changes. | 215 | 48 | 131 | 108 | 67.30 | 28 | —— | Positive |
| 6 | Fever, joint pain, fatigue, limb weakness and urination and defecation function disturbance | Paralysis of limbs, positive pathological signs and abnormal sensation | Spinal cord injury | - | MRI of the thoracic spine and cervical spine showed no abnormality. | 210 | 195 | 203 | 118 | 41.10 | 9 | —— | Positive |
| 7 | Fatigue, hearing loss, limb weakness, urination and defecation function disturbance | Paralysis of limbs, positive pathological signs and abnormal sensation | Central demyelination, spinal cord damage | 8 | Head MRI showed multiple abnormal signals in bilateral cerebellar middle pedunculus, pons, bilateral temporal lobes, and bilateral lateral ventricles. | 190 | 62 | 115 | 121 | 14.10 | 39 | —— | Positive |
| 8 | Fever, weight loss, confusion | Positive pathological signs, abnormal sensation and ataxia | Central demyelination, spinal cord damage | 2 | MRI of the head showed an abnormal signal in the white matter of the right parietal lobe and an irregular flaky signal in the right temporal lobe with circular enhancement. | 175 | 130 | 138 | 125 | 25.30 | 29 | —— | Positive |
| 9 | Fever, hearing loss | Ataxia | —— | 8 | Head MRI showed lacunar cerebral infarction and white matter degeneration. | 300 | 246 | 330 | 111 | 99.70 | 30 | Positive(blood) | Positive |
| 10 | Blurred vision | Eye movement disorder | meningitis | 3 | MRI of the head showed no abnormality. | 150 | 74 | 157 | 113 | 17.80 | 35 | Negative | Positive |
| 11 | Fever, fatigue, hearing loss, limb weakness and urination and defecation function disturbance | Mental and behavioral abnormalities, limb paralysis, positive pathological signs, sensory abnormality, eye movement disorder and ataxia | Encephalitis, central demyelination, spinal cord damage | 8 | Head MRI showed demyelinating changes in white matter. | 130 | 46 | 121 | 116 | 36.40 | 43 | Negative | Positive |
| 12 | Myalgia | Positive pathological sign | spinal cord damage | - | Head MRI showed space-occupying lesions, complex cysts, and postoperative changes in the pineal region. | 115 | 136 | 438 | 119 | 69.10 | 38 | Negative | Positive |
| 13 | Fever, headache | Meningeal irritation sign, and pathological signs were positive | meningitis | 3 | MRI of the head showed multiple abnormal signals in bilateral frontal and parietal lobes, and ischemic lesions were considered first, except inflammatory changes. | 310 | 270 | 120 | 111 | 12.90 | 33 | Positive (CSF) | Negative |
| 14 | Fever, fatigue, hearing loss, limb weakness and urination and defecation function disturbance | Paralysis of limbs, positive pathological signs and abnormal sensation | spinal cord damage | 8 | —— | 170 | 173 | 466 | 95 | 238.00 | 29 | —— | Positive |
| 15 | Fever, fatigue, limb weakness | None | —— | - | MRI of the head showed widening of the perivascular space in the left thalamus. | 240 | 119 | 209 | 110 | 28.00 | 33 | —— | Positive |
| 16 | Fever | Sensory abnormality | Spinal cord injury, peripheral nerve demyelination | - | MRI of the cervical spinal cord showed abnormal signal in the spinal cord at C2/3 level. | 180 | 91 | 169 | 110 | 62.30 | 25 | —— | Positive |
| 17 | Fatigue, limb weakness, urination and defecation function disturbance | Paralysis of limbs, positive pathological signs, abnormal sensation and ataxia | spinal cord damage | - | MRI of the head showed abnormal signal in the right lenticular nucleus, and the perivascular space may be. | 175 | 171 | 197 | 114 | 37.60 | 21 | Positive (blood) | Positive |
| 18 | Fever, headache, fatigue, hearing loss, limb weakness, and urination and defecation function disturbance | Paralysis of limbs with positive pathological signs | Meningitis, encephalitis, spinal cord damage | 8 | Head MRI showed multiple white matter degeneration and abnormal signal of gray matter in the brain, which may lead to encephalitis. Partially empty sella turcica. No obvious enhancement was found. | —— | 68 | 384 | 107 | 52.40 | 28 | —— | Positive |
| 19 | Fever, fatigue, hearing loss, and confusion | Positive pathological signs and abnormal sensation | spinal cord damage | 8 | —— | 145 | 14 | 83 | 119 | 27.80 | 59 | —— | Positive |
| 20 | Fever, fatigue, hearing loss, limb weakness and urination and defecation function disturbance | Paralysis of limbs, positive pathological signs and abnormal sensation | spinal cord damage | - | MRI of thoracic vertebrae showed Schumer nodules in thoracic vertebrae 10. | 135 | 14 | 84 | 123 | 12.80 | 29 | Positive (CSF) | —— |
| 21 | Weakness of both lower limbs and urination and defecation function disturbance | Paralysis of limbs with positive pathological signs | spinal cord damage | - | MRI showed no abnormality in the thoracic spinal cord | 205 | 9 | 160 | 126 | 21.70 | 29 | Positive (blood) | —— |