Onco-neurology is an emerging multi-disciplinary sub-specialty dedicated to the study of the indirect effects of tumors and their therapeutic processes on the nervous system. Its core lies in elucidating the complex pathophysiological mechanisms by which tumors induce neurological dysfunction through non-metastatic mechanisms. The Neurology and Oncology Departments of Renji Hospital, Shanghai Jiao Tong University School of Medicine, have accumulated extensive experience in the clinical practice of onco-neurology, providing comprehensive and personalized medical care to patients with oncological neurological complications through a multi-disciplinary collaboration model. This article, for the first time, introduces the concept of onco-neurology and elaborates on its classification, diagnosis, and treatment essentials. It aims to establish an organic intersection between oncology and neurology from an academic perspective, providing theoretical guidance and practical instructions for enhancing the efficacy of tumor treatment and reducing nervous system-related adverse effects in clinical practice, ultimately improving tumor patients' quality of life and survival outcomes.
Objective: To report the clinical characteristics and rehabilitation course of a patient who developed rhabdomyolysis with peripheral nerve injury following combined quetiapine and alcohol intoxication, and to review the literature to enhance understanding of quetiapine intoxication and emphasize the importance of early rehabilitation intervention in patients with concomitant peripheral nerve injury to improve prognosis.
Methods: The clinical characteristics, electromyography findings, and rehabilitation course of a patient who developed rhabdomyolysis with peripheral nerve injury following combined quetiapine and alcohol intoxication were described in detail, and the relevant literature was reviewed.
Results: A 14-year-old female was admitted with a 20-day history of bilateral lower limb weakness. Following quetiapine combined with alcohol intoxication, decreased muscle strength in both lower limbs developed, resulting in inability to stand or walk, and peripheral nerve damage in both lower limbs was indicated by electromyography. After two weeks of rehabilitation training, improvements were observed in the lower limb muscle strength, balance function, and activities of daily living. At two months after onset, the patient was able to stand with support between parallel bars for 30 min, and at one year, she was able to walk independently indoors with the aid of a walker.
Conclusion: Although the mechanism underlying peripheral neuropathy caused by quetiapine intoxication remains unclear, functional recovery can be improved by early and intensive rehabilitation.
Rare neurological diseases account for approximately 60% of all rare diseases, representing a category with a relatively large patient population and wide-ranging impact. These disorders are highly heterogeneous, with complex clinical manifestations that may involve neuromuscular, metabolic, immune, or developmental pathways. As a result, they are difficult to diagnose and prone to misdiagnosis. Currently, there is no internationally unified classification standard specifically for rare neurological diseases. In clinical practice, these conditions often face challenges such as delayed diagnosis and limited access to treatment. This article reviews the classification, diagnosis, and treatment of rare neurological diseases, aiming to provide clinical reference.
Narcolepsy (NC) is a rare chronic neurological disorder. Current western medical treatments (such as central stimulants, antidepressants, and sodium gamma-hydroxybutyrate) primarily aim to reduce excessive daytime sleepiness, control cataplexy, and improve nighttime sleep, thereby alleviating clinical symptoms. However, long-term use of western medications may lead to issues such as drug dependence, drug resistance, and adverse effects. In contrast, traditional Chinese medicine (TCM), guided by the principles of "treatment based on syndrome differentiation" and "holistic regulation", offers unique advantages in improving NC symptoms, reducing the risk of disease recurrence, and enhancing quality of life. It can compensate for the limitations of western medicine, reduce dosage requirements of western drugs, and mitigate their side effects, thereby improving treatment safety. Additionally, TCM may delay cognitive impairment and protect brain function. Therefore, this study systematically reviews recent advances in both western medicine and TCM for the treatment of NC, and further explores the benefits of integrated western and TCM approaches under a holistic medical model, with the aim of optimizing clinical strategies and providing new insights for the management of NC.
Multiple system atrophy (MSA) is a sporadic progressive neurodegenerative disease that is mainly categorized into Parkinsonism (MSA-P) and cerebellar (MSA-C) types. Its core clinical features include rapidly progressive autonomic failure and motor dysfunction. Currently, the etiology of MSA is unknown and involves multiple pathogenic mechanisms, therefore, treatment is limited to symptomatic management, and there is a lack of effective disease-modifying therapy (DMT) to slow down disease progression. Current research focuses on exploring diagnostic and therapeutic strategies combining traditional Chinese and western medicine, such as targeting α-synuclein pathology, regulating neuroinflammation, and enhancing neurotrophic support. Basic research and early clinical trials are evaluating the potential of various treatment options. This review aims to summarize the biological mechanisms of MSA and the latest research advancements, in order to facilitate clinical understanding of targeted treatment strategies for MSA.
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, and its pathogenesis is complex and has not been fully elucidated. In recent years, the dysregulation of the gut-brain axis (GBA) is considered to play an important role in the pathogenesis and progression of ALS. Intestinal microbiota and their metabolites, intestinal barrier function, immune system activation, and neuroinflammation communicate bidirectionally with the central nervous system through GBA, thereby influencing the pathological process of ALS. Meanwhile, various active components of Chinese herbal medicine have shown significant potential in regulating GBA function, improving gut microenvironment, and alleviate neuroinflammation. For instance, berberine can activate autophagy to clear TAR DNA-binding protein 43 (TDP-43) aggregates; ginsenoside and its non-saponin component Gintonin can inhibit the TLR4-LPA1 signaling pathway to regulate neuroinflammatory responses; ligustrazine derivative tetramethylpyrazine nitrone (TMPN) can enhance the mitochondrial antioxidant function mediated by PGC1-α (peroxisome proliferator-activated receptor gamma coactivator 1-α); the 7,8-dihydroxyflavone (7,8-DHF) prodrug R13 can activate the TrkB-AMPK pathway to improve neuronal energy metabolism. This paper systematically reviews the mechanism of GBA in the pathogenesis and development of ALS, and focuses on discussing the potential mechanisms and research progress on Chinese herbal medicine interventions for ALS through the modulation of GBA function, aiming to provide new strategies and insights for ALS treatment.
Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder mediated by pathogenic autoantibodies. Although modern medicine offers effective short-term symptom control, its long-term treatment is limited by adverse drug reactions, complications, and disease recurrence. Integrated traditional Chinese and western medicine (ICWM) has demonstrated potential advantages in the immunomodulatory treatment of MG. Various traditional Chinese medicine (TCM) monomers and compound prescriptions exert therapeutic effects through multiple mechanisms, including suppression of autoantibody production, regulation of cellular immune imbalance, inhibition of complement activation, and modulation of cytokine networks and signaling pathways. These actions help restore neuromuscular junction function and alleviating MG symptoms. Furthermore, combining TCM with conventional therapies may help reduce adverse reactions, enhance remission rates, and improve the patients' quality of life. This also provides new insights into personalized treatment strategies. However, current experimental and clinical research on ICWM for MG still requires further refinement and standardization to meet higher scientific rigor.
This study retrieved literature on fire needle therapy for bulbar palsy from the China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journals Database, Wanfang Data Knowledge Service Platform, SinoMed, PubMed, Cochrane Library, Web of Science, and EBSCO Medline, spanning from the inception of the databases to March 1, 2025. The selected literature was categorized and analyzed based on acupuncture point selection, treatment methods, and therapeutic mechanisms. A total of 19 Chinese articles and 3 English articles were included. The five most frequently used acupoints were Zusanli, Lianquan, Fengchi, Quchi and Hegu. Extraordinary points were predominantly selected based on local symptoms. This study summarized common acupoints to provide guidance for fire needle therapy in bulbar palsy, highlighting its clinical value and offering new treatment perspectives for the condition. However, significant gaps remain in research on individualized treatment under syndrome differentiation and mechanism studies, warranting further investigation.
Bladder dysfunction is a common complication following spinal cord injury (SCI), significantly impacting patients' quality of life. Appropriate bladder management is crucial for improving outcomes and enhancing quality of life. This article provides a brief overview of non-surgical management strategies for bladder dysfunction following SCI, including ultrasound assessment, urodynamic studies, pharmacotherapy, posterior tibial nerve stimulation, and triggered voiding, aiming to offer guidance for bladder management in SCI patients.
The prevalence of late-life depression (LLD) among people over 60 years old worldwide is as high as 28.4%, and the incidence rate of LLD in China is 31.21%. Its clinical manifestations are mainly physical symptoms and cognitive impairment, which are easily misdiagnosed as physical diseases. Neuroimaging studies have revealed that the pathological mechanism of LLD is closely related to abnormal brain structure and function, including reduced gray matter volume in brain regions such as the prefrontal lobe and hippocampus, excessive activation of the default mode network (DMN), and weakened connections of the executive control network. These findings provide targets for neuroregulation therapy. The response rate of traditional antidepressant drugs is only 50%, and some have cardiovascular and cognitive risks. However, non-invasive neuroregulation techniques have shown significant potential. Electroconvulsive therapy (ECT) has a remission rate of over 50% for severe patients, but it has obvious cognitive side effects. Magnetic seizure therapy achieves focal epileptic seizures through precise magnetic field stimulation, with efficacy comparable to that of ECT and less cognitive impact. Bilateral repetitive transcranial magnetic stimulation (TMS) and deep TMS(dTMS) are recommended as first-line regimens. Transcranial direct current stimulation is suitable for patients with mild to moderate conditions due to its high safety. In the future, it is necessary to optimize individualized parameters by integrating multi-modal assessment, explore combined therapies and telemedicine applications, in order to improve the diagnosis and treatment effect of LLD.
Objective: Neuromodulation techniques represent an emerging approach in rehabilitation medicine. This study aimed to explore the multi-dimensional constraints hindering their implementation in community hospitals, as well as their potential advantages, limitations, and strategic recommendations for broader adoption.
Methods: Using a purposeful sampling method, six community hospitals with demonstration-level rehabilitation centers in Xuhui District, Shanghai, were selected between June 2024 and December 2024. A mixed-methods design was employed, including questionnaires administered to rehabilitation department heads and medical staff (n = 64), along with in-depth individual interviews (9 managers and 6 rehabilitation therapy teams). This approach systematically evaluated the current status of neuromodulation technology adoption and its influencing factors in community healthcare settings.
Results: Key findings revealed a critical shortage of certified rehabilitation physicians (23.8% of total rehabilitation department physicians). Questionnaire-based scoring (x±s) highlighted three major barriers for the implementation of neuromodulation techniques in community healthcare centers: high financial burden of equipment (7.50±2.34; top 1), technical complexity of operations (6.75±2.47; top 2), and insufficient healthcare policy support (6.64±2.80; top 3).
Conclusion: The application of neuromodulation techniques in community-based rehabilitation faces significant challenges. To address these, efforts should be made to strengthen the workforce and professional training in the department of rehabilitation medicine in community hospitals. It is recommended to establish a systematic continuing education program in rehabilitation medicine to enhance healthcare personnel's professional competence and sense of recognition. Additionally, enhanced policy support, centralized procurement of equipment, and tiered resource allocation are essential to reduce economic barriers. These strategies may facilitate the integration of neuromodulation technologies into community healthcare, ultimately improving rehabilitation service quality and patient outcomes.
