Department of Neurology, University of California San Francisco, 505 Parnassus Avenue, Box 0114, San Francisco, CA 94143, USA.
Neurol Clin. 2022 Feb;40(1):93-112. doi: 10.1016/j.ncl.2021.08.007.
Meningitis and encephalitis are inflammatory syndromes of the meninges and brain parenchyma, respectively, and may be identified either by finding definitive evidence of inflammation on tissue pathology or by cerebrocpinal fluid (CSF) analysis showing pleocytosis or intrathecal antibody synthesis. Clinicians evaluating undifferentiated meningitis or encephalitis should simultaneously consider autoimmune, infectious, and neoplastic causes, using patient risk factors, clinical syndrome, and diagnostic results including CSF and MRI findings to narrow the differential diagnosis. If an autoimmune cause is favored, an important early diagnostic question is whether a specific neural autoantibody is likely to be identified.
脑膜炎和脑炎分别是脑膜和脑实质的炎症综合征,可以通过组织病理学上发现明确的炎症证据或通过脑脊液(CSF)分析显示白细胞增多或鞘内抗体合成来确定。评估未分化的脑膜炎或脑炎的临床医生应同时考虑自身免疫、感染和肿瘤原因,利用患者的危险因素、临床综合征和诊断结果,包括 CSF 和 MRI 结果,来缩小鉴别诊断范围。如果倾向于自身免疫原因,则一个重要的早期诊断问题是是否可能确定特定的神经自身抗体。