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Zhang Hui
Neurology
About me
Weifang People's Hospital, Department of Neurology, attending physician, has been engaged in clinical work in the field of neurology for many years, with rich clinical experience in common and prevalent neurological diseases.
Proficient in diseases
Cerebrovascular disease, Parkinson's disease, myelitis, etc.
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How is encephalitis caused?
Encephalitis generally occurs when pathogens invade the central nervous system of the brain, resulting in corresponding clinical manifestations. Patients may exhibit symptoms such as headache, fever, nausea, vomiting, and even paralysis of limbs and cognitive impairments. Patients become confused, with reduced computational and comprehension abilities. Some may also exhibit psychiatric symptoms and even experience seizures and other manifestations of epilepsy. Encephalitis is caused by pathogens, commonly viruses. Viral infections that lead to what is known as viral encephalitis can spread through the bloodstream to the brain and cause illness. Additionally, bacterial infections can also cause encephalitis. There are mainly two routes for bacterial infections: one is through bloodstream transmission leading to inflammation of the nervous system, and the other can occur directly, for example, from inflammation of the mastoids, tonsils, or cavernous sinus, where bacteria directly invade the brain, leading to the respective clinical manifestations. Furthermore, tuberculosis can also infect and cause tuberculous encephalitis, meningitis, and similar conditions.
What tests are done for optic neuritis?
Optic neuritis is generally caused by demyelinating diseases, including common conditions such as neuromyelitis optica, multiple sclerosis, and retrobulbar neuritis. These diseases can severely impact the patient's vision and create significant burdens. Typically, examinations of the optic nerve are required, covering several aspects. First, an examination of the fundus is necessary, generally using an ophthalmoscope or other devices to observe the optic disc and surrounding blood vessels, which is very important. Second, a visual evoked potential test can be conducted. This test helps assess whether there is damage to the optic nerve and the severity of the damage. Third, it is necessary to complete an MRI of the optic nerve. Evaluations might include a lumbar puncture to analyze cerebrospinal fluid, and complete tests related to water channels, protein antibodies, oligoclonal bands, etc., to help confirm the diagnosis.
Can optic neuritis patients run?
Patients with optic neuritis generally suffer from demyelinating diseases of the central nervous system. In addition to optic neuritis, it can also affect the spinal cord, causing inflammation of the spinal cord. The nature of this disease is caused by the disorder of the body’s immune function. During the acute phase of the disease, the body is relatively weak, and the immune function is disordered; it is suitable for rest in bed. It is not recommended to engage in high-intensity exercise like running, as it is not beneficial for the recovery of the disease; this stage should focus on rest. If optic neuritis has been treated with corticosteroids and other treatments and the clinical symptoms have alleviated, and the patient's physical function has significantly recovered, it is then advisable to engage in running to exercise the body and enhance physical fitness. Participating in these physical activities can improve the patient's immune function and may prevent another attack.
Types of Myasthenia Gravis Crisis
Myasthenia gravis is a neurological disease. It is an autoimmune disorder primarily affecting the neuromuscular junction, leading to symptoms such as pathological fatigue, ptosis, and limb weakness. Myasthenia gravis is termed as such due to its severe nature, including crises that can impair respiratory muscles, leading to respiratory paralysis, respiratory failure, and potentially death. There are three main types of myasthenic crises. The first type is myasthenic crisis, primarily caused by insufficient medication; muscular injections can be used for treatment, and if effective, it indicates a myasthenic crisis. The second type is called cholinergic crisis, resulting from an overdose of acetylcholinesterase inhibitors, with symptoms including muscular twitching and pupil constriction. The third type is called refractory crisis, occurring when the body is insensitive to medication treatments. All these crises pose a life-threatening risk to patients and require immediate management, including tracheal intubation and, if necessary, mechanical ventilation.
How is optic neuritis diagnosed?
Optic neuritis is classified as an ophthalmological or neurological disorder, caused by demyelination of the central nervous system. Diagnosis of this condition is crucial, and the following tests are recommended: Firstly, visual evoked potentials should be performed. This test can clearly show the corresponding lesions in the optic nerve. Secondly, magnetic resonance imaging (MRI) of the optic nerve is needed. MRI can reveal changes in the optic nerve, such as thickening and edema. Thirdly, some blood tests related to bleeding should be conducted. Specifically, testing for aquaporin-4 antibodies to determine if it is neuromyelitis optica. Additionally, a lumbar puncture is also necessary. This primarily aims to check for demyelination markers, such as oligoclonal bands. Once optic neuritis is diagnosed, timely treatment is required, mainly using corticosteroids or intravenous immunoglobulin.
How to relieve neuralgia
Firstly, symptomatic treatment can be administered to patients. Medications for treating neuralgia mainly include tricyclic antidepressants and anticonvulsants, and serotonin reuptake inhibitors may also be effective. These medications should be taken under the advice of a doctor when necessary to help alleviate pain. Secondly, localized block treatment can also achieve certain clinical effects. Thirdly, it is crucial to identify the cause of the neuralgia and treat it accordingly. For example, if a patient’s neuralgia is caused by optic neuromyelitis, corticosteroids should be used; if it is due to herpes zoster virus infection, antiviral medications are required.
What are the symptoms of encephalitis?
The clinical manifestations of encephalitis are complex and varied, primarily caused by infections from pathogens such as viruses and bacteria. There are numerous clinical symptoms, with fever being quite common; patients generally exhibit significant fevers, which can reach up to 38 degrees Celsius or even as high as 40 degrees Celsius. Headache is also a very common clinical manifestation of encephalitis, with some patients experiencing severe headaches accompanied by pronounced nausea and vomiting. Additionally, some patients may exhibit psychiatric symptoms, which mainly include incoherent speech, hallucinations, and failing to recognize family members. Some patients may experience cognitive impairments, such as diminished memory, and significant deficits in computational and judgment abilities. In severe cases, some patients may have epileptic seizures, characterized by convulsions of the limbs. Overall, the manifestations of encephalitis are diverse and can range from simple fever and headache to severe conditions such as psychiatric symptoms, cognitive impairments, and epilepsy.
What is myasthenia gravis?
Myasthenia gravis is a group of neuromuscular junction disorders and is also an autoimmune disease of the nervous system. It primarily involves the production of certain antibodies in the body that attack the acetylcholine receptors on the postsynaptic membrane of the neuromuscular junction. This results in the inability of nerve impulses to be effectively transmitted to the muscles, causing the muscles to lose neural control, leading to weakness of the limbs. This weakness is typically more pronounced in the evening than in the morning, with symptoms being lighter upon waking and worsening in the afternoon. As the disease is caused by an autoimmune response, a major focus of treatment is to suppress this abnormal immune reaction, primarily through the administration of corticosteroids. Additionally, many patients with myasthenia gravis also exhibit thymus abnormalities, necessitating thorough CT examinations of the thymus.
Differentiation between subarachnoid hemorrhage and cerebral hemorrhage
Subarachnoid hemorrhage and cerebral hemorrhage, though both involve bleeding, have different mechanisms of onset. The first distinction is that cerebral hemorrhage is generally caused by hypertension. Hypertension leads to hyaline degeneration and fibrinoid necrosis of arteries, resulting in bleeding. In contrast, the most common cause of subarachnoid hemorrhage is an aneurysm, which may be related to factors such as smoking and congenital developmental abnormalities. In terms of clinical presentation, cerebral hemorrhage has a sudden onset, with symptoms of headache, nausea, vomiting, but also includes impairments in language functions, and signs of neurological deficits such as limb paralysis. Subarachnoid hemorrhage, on the other hand, typically involves very severe pain, usually without manifestations such as limb paralysis. Furthermore, from a radiological perspective on CT imaging, cerebral hemorrhage is mainly located in the brain parenchyma, while subarachnoid hemorrhage mainly indicates that the site of bleeding is in the subarachnoid space.
Can senile dementia be cured?
Dementia in the elderly is a clinical syndrome caused by the irreversible death of neurons. So far, the mechanism of the disease is not particularly clear, making it very difficult to cure dementia completely. However, there are some corresponding treatment methods that can delay the progression of the disease and improve the quality of life of patients as much as possible. These treatments mainly include exercise therapy, which involves getting patients to participate in appropriate physical activities that can promote cognitive development. In addition, letting patients listen to music more often, interact more with others, and continue learning can also delay the progression of aging. Furthermore, there are some medications that can improve the symptoms of dementia. Currently, the most commonly used worldwide are acetylcholinesterase inhibitors, which can increase the levels of acetylcholine and thereby improve cognitive function to some extent and slow the progression of the disease. Additionally, if elderly individuals exhibit some psychiatric symptoms, they can also be given some atypical antipsychotic medications to alleviate the condition.