Croft P B
Postgrad Med J. 1969 Jun;45(524):392-400. doi: 10.1136/pgmj.45.524.392.
The incidence of encephalomyelitis in association with acute specific fevers and prophylactic inoculations is discussed. Available statistics are inaccurate, but these conditions are of considerable importance—it is likely that there are about 400 cases of measles encephalitis in England and Wales in an epidemic year. The pathology of these neurological complications is discussed and emphasis placed on the distinction between typical perivenous demyelinating encephalitis, and the toxic type of encephalopathy which occurs mainly in young children. The clinical syndromes occurring in association with measles, chickenpox and German measles are considered. Although encephalitis is the most frequent complication, myelitis and polyradiculitis also occur. There is evidence that ‘uncomplicated measles’ is associated with brain involvement in the prodromal phase. Similar para-infectious disorders occur in association with other infections including smallpox and influenza. The post-vaccinal types of encephalomyelitis are also considered with particular reference to post-vaccinial encephalitis and rabies post-vaccinal encephalitis. The pathogenesis of these disorders is discussed and it is concluded that there is direct viral invasion of the nervous system, followed by an antigen-antibody reaction. At times virus may remain latent within the nerve cell without destroying it.
本文讨论了与急性特异性发热及预防性接种相关的脑脊髓炎发病率。现有统计数据并不准确，但这些情况相当重要——在疫情年，英格兰和威尔士可能有大约400例麻疹脑炎病例。文中讨论了这些神经并发症的病理学，并强调了典型的静脉周围脱髓鞘性脑炎与主要发生在幼儿中的中毒性脑病类型之间的区别。文中还考虑了与麻疹、水痘和风疹相关的临床综合征。虽然脑炎是最常见的并发症，但脊髓炎和多发性神经根炎也会发生。有证据表明，“无并发症的麻疹”在前驱期与脑部受累有关。类似的感染后疾病也与包括天花和流感在内的其他感染有关。文中还特别参考接种疫苗后脑炎和狂犬病接种疫苗后脑炎，对疫苗接种后脑脊髓炎的类型进行了讨论。文中探讨了这些疾病的发病机制，并得出结论，存在病毒对神经系统的直接侵袭，随后发生抗原抗体反应。有时病毒可能潜伏在神经细胞内而不破坏它。
