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To report a typical case of Morvan syndrome with positive anti-leucine rich glioma-inactivated 1(LGI1) and contactin-associated protein 2 (CASPR2) antibodies in serum and cerebrospinal fluid. A 39-years-old female initially presented weakness of extremeties. The main symptoms included paroxysmal limb pain, wheezing, itching, muscle twitching, epilepsy, hypomnesia, dysphoria, apathy, intractable insomnia, salivation and sweating. Tests of electrolytes found hypokalemia (2.7-3.1 mmol/L) and hyponatremia (130-136 mmol/L). Arterial blood gas analysis showed hypoxemia (oxygen saturation 50%-70%). Total thyroxine (TT4) was elevated to 207 nmol/L with positive thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab). LGI1and CASPR2 antibodies (CBA method) were positive in both serum and cerebrospinal fluid, and the remaining antibodies related to autoimmune encephalitis and paraneoplastic syndrome were negative. Head MRI was almost normal, while mild abnormalities were found in electroencephalogram. Electromyography showed slightly increased voltage of left quadriceps motor unit potential. After treated with corticosteroids, IVIG and mycophenolate mofetil, the patient completely improved. Cognitive function scores recovered from MoCA/MMSE (16/24) to MoCA/MMSE (26/29). Positivity of LGI1/CASPR2 antibodies both in serum/cerebrospinal fluid are rarely seen in patients with Morvan syndrome. Steroids and immunosuppressants are suggested for treatment as early as possible.本文报道血清及脑脊液富亮氨酸胶质瘤失活蛋白1（LGI1）和接触蛋白相关样蛋白2（CASPR2）抗体四阳性导致的典型Morvan综合征1例患者的临床特点及预后。对该Morvan综合征患者行详细的病史询问和体格检查、多次脑脊液检查、头颅影像学、电生理检查以及预后进行分析。临床特点：患者青年女性，39岁，首发症状表现为四肢无力，病程中主要症候包括发作性肢体疼痛、憋喘、瘙痒、肌颤搐、癫痫、记忆力减退、烦躁、淡漠、顽固性失眠、流涎、出汗异常。实验室检查：电解质示低钾血症（2.7~3.1 mmol/L）、低钠血症（130~136 mmol/L）；血气分析示低氧血症（氧分压50%~70%）。甲状腺功能：总甲状腺腺素（TT4）207 nmol/L、甲状腺过氧化物酶抗体（TPO-Ab）15.3 IU/ml、甲状腺球蛋白抗体（TG-Ab）16.9 IU/ml；血清和脑脊液抗LGI1/CASPR2抗体呈四阳性，其他自身免疫相关脑炎及副肿瘤综合征相关抗体均阴性。头颅MRI未见异常；脑电图轻度异常；肌电图示左股四头肌运动单位电位电压略高。治疗及预后：激素+丙种球蛋白+吗替麦考酚酯片联合治疗，患者临床症状完全缓解。治疗前后认知功能评分：治疗前蒙特利尔认知评估量表（MoCA）/简易智力状态检查（MMSE）（16分/24分）、治疗后MoCA/MMSE（26分/29分）。Morvan综合征血清/脑脊液中LGI1/CASPR2抗体四阳性罕见，但临床症候典型，尽早免疫治疗效果显著。.

To explore the clinical characteristics of vestibular migraine in patients from the clinic and ward of the neurological department in comprehensive hospitals.A total of 226 patients diagnosed as vestibular migraine were enrolled in the study. Clinical data were collected and analyzed, including the medical history, clinical symptoms and signs, as well as the result of diagnostic examinations.The mean age of the patients at the visit was 51.7 years old, with the male to female ratio of 1: 1.48. The occurrence of vertigo and migraine varied in order, with 53.1% (120/226) patients presented migraine several years before vertigo. The duration time of vertigo ranged from seconds to days, with 1.8% (4/226) patients presented no headache during the whole course. Several punctate long T(2) or high FLARE (fluid attented inversion recovery) signals scattered at the centrum ovale.Vestibular migraine has complex mechanism and presents multiple clinical manifestations with certain regularities of the onset. Differential diagnosis should be made from the similar diseases.

To accumulate clinical experience and to direct clinical work.A total of 208 patients with psychogenic dizziness from department of neurology of Navy General Hospital of PLA were included in the study. Self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Bech-Rafaelsen mania rating scale (BRMS) were used for the evaluation.Among all the patients aged from 17 to 77 (the average age: 52), 152 were female and 56 were male. There were 3 types according to different clinical features and therapy prognosis: anxiety and depression type (176 cases, 84.6%) , hysteria type (18 cases, 8.7%) and mania type (14 cases, 6.7%) . The drugs increasing the concentration of excitatory had a good therapeutic efficacy on anxiety and depression type. Alluding cure had notable effect on hysteria type and mood stabilizer had notable effect on mania type.Women tended to have psychogenic dizziness. It can be divided into three types: anxiety and depression type, hysteria type and mania type. Clinical symptoms and laboratory examination of each type have their own characteristics, and treatment strategies are also different.

To explore the clinical features, neuroimaging and histopathological findings in patients with idiopathic hypertrophic cranial pachymeningitis (IHCP) with a nodular space occupying effect.Four IHCP cases with a nodular space occupying effect diagnosed in our hospital were retrospectively studied.All the 4 patients were men with a mean onset age of 40.25 (33 ∼ 50) years old. They all had long disease duration and relapses. The common symptoms of IHCP were chronic headache, multiple cranial nerve palsies and epileptic seizures. CT and MRI of the brain revealed prominent dural partial thickening, which indicated a mass or nodular space occupying effect that mimicked intracranial tumour-like meningioma. The histopathological findings of dura in 2 cases revealed connective tissue proliferation, scattered neutrophil granulocytes and plasmacytes infiltration. Combination therapy of corticosteroid or/and immunosuppressive drugs was effective for the IHCP patients.IHCP patients with a nodular space occupying effect usually onset with chronic headache and are often recurrent. The combination therapy of corticosteroid or/and immunosuppressive drugs is effective. The image of the brain presents prominent dural partial thickening, indicating a mass or nodular space occupying effect, which often lead to confusion with intracranial tumours or granulomatosis.

To determine the clinical characteristic and common etiologies of cerebral venous thrombosis (CVT) in China.Clinical and neuroimaging data of 91 cases of CVT were analyzed retrospectively.91 CVT patients (49 men, 42 women), aged from 9 to 57 years, were diagnosed with MRI (78 cases, 85.71%), MRA (37 cases, 40.66%) or DSA (32 cases, 35.16%). 27 cases (29.67%) had a clinical pattern of isolated intracranial hypertension, 56 cases (61.54%) of focal deficits and/or seizures, 3 cases of subacute encephalopathy and 5 cases of cavernous sinus thrombosis. Oral contraceptive was the most common cause, being found in 12 cases (13.19%).Understanding of the clinical characteristics of CVT and using of MRI and MRA examination as early as possible is the key in CVT diagnosis. Oral contraceptive is the most common etiology.