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.

Objective: To report the first real-world case of an Alzheimer's disease patient who achieved PET-defined amyloid clearance sufficient to meet the discontinuation criteria and successfully discontinue donanemab therapy, and to illustrate the feasibility of PET-guided individualized treatment duration in clinical practice.

Methods: A 78-year-old female patient with AD was systematically evaluated before and after donanemab therapy. Cognitive function, amyloid-β (Aβ) and Tau PET imaging, and MRI findings were longitudinally monitored, along with the assessment of treatment-related adverse events.

Results: After six infusions of donanemab, the patient's Aβ load decreased to 7.02 Centiloids (CL), meeting the predefined discontinuation criterion. Tau deposition showed a mild visual reduction compared with baseline. The MoCA score increased from 17 to 21, mainly in the orientation domain, while activities of daily living remained stable. Asymptomatic amyloid-related imaging abnormalities (ARIA) was detected and remained stable during follow-up

Conclusion: This case demonstrates that donanemab can achieve substantial Aβ clearance with favorable safety in real-world settings. PET-based quantitative guidance for individualized therapy duration appears feasible, though long-term follow-up is required to assess the durability of Aβ clearance and its downstream impact on Tau dynamics and clinical outcomes, providing insights for precision application of anti-Aβ therapies.

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.

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.

Autoimmune encephalitis (AE) is a group of inflammatory disorders caused by immune-mediated attacks on the central nervous system, with common clinical manifestations including psychiatric and behavioral abnormalities, cognitive and motor impairments and epileptic seizures. Conventional first-line therapies mainly rely on corticosteroids, intravenous immunoglobulin, and plasma exchange. However, a subset of patients exhibits suboptimal responses or high relapse rates, underscoring the urgent need for the development of novel therapeutic strategies. In recent years, targeted therapeutic approaches have advanced rapidly in the field of AE, primarily focusing on key immune components such as B cells, T cells, the complement cascade, and key inflammatory cytokines. Anti-CD20 monoclonal antibodies have demonstrated promising efficacy in refractory AE. Moreover, emerging agents such as ocrelizumab, epratuzumab, telitacicept, and daratumumab have provided refined strategies for the precise depletion of B cells and plasma cells. In parallel, cytokine-targeting biologics, Janus kinase inhibitors, and the proteasome inhibitor bortezomib have shown potential value for modulating aberrant immune responses. In addition, chimeric antigen receptor (CAR)-T cell immunotherapy is gradually emerging as an important frontier in exploratory research. Looking ahead, by integrating neurorestorative strategies with artificial intelligence-assisted diagnostic and therapeutic decision-making, targeted therapies are expected to drive AE management from traditional empirical immunosuppression toward a new era of precision intervention, thereby enabling more efficient and personalized disease management.

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.

Epilepsy is a chronic brain disease characterized by central nervous system dysfunction, and its frequent seizures have a serious impact on the quality of life for patients. At present, the primary treatment is based on Western anti-epileptic medications; however, long-term use of these drugs can lead to a series of adverse reactions. Chaihu Jia Longgu Muli Decoction, mentioned in Article 107 of the On Cold Damage (Shang Han Lun), has been commonly used by both ancient and modern physicians to treat mental and emotional diseases such as "chest fullness and agitation". In recent years, many studies have shown that this formula has a significant efficacy in treating epilepsy. Chaihu Jia Longgu Muli Decoction can exert its anti-epileptic effects by regulating neurotransmitters, enhancing the function of central nervous systems cells, and modulating inflammatory markers. This formula serves multiple functions, including harmonizing the Shaoyang, Tongyang Xiezhuo, and tranquilizing mind. Its effects are multi-targeted and systemic in nature. In the clinical treatment of patients with epilepsy, Chaihu Jia Longgu Muli Decoction has played an important role. This article offers a comprehensive overview of the recent developments regarding this formula's application in epilepsy treatment, focusing on the prescription compatibility, its underlying mechanisms of action, and relevant clinical observations.

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.

Parkinson's disease (PD) is a common neurodegenerative disorder whose pathogenesis is complex and remains incompletely understood. Oligomers formed by the abnormal aggregation of α‍-synuclein (α‍-syn) are considered one of the central culprits of PD pathology. These oligomers accumulate not only within neurons but also propagate pathological changes by mediating neuron-glia crosstalk. Accumulating evidence indicates that α‍-syn oligomers exacerbate neuronal injury and accelerate neurodegeneration by triggering glial activation and inflammatory responses. Nevertheless, the precise molecular mechanisms through which α-syn oligomers transduce signals between neurons and glia are still largely unresolved. Here we systematically review the biogenesis and toxic mechanisms of α-syn oligomers, the activation states of glial cells and their associated inflammatory pathways, and the latest advances in intercellular signaling between the two compartments, with the goal of illuminating the pivotal roles of these processes in PD pathobiology. By integrating these molecular insights, we aim to provide new theoretical frameworks and research directions for the early diagnosis and treatment of Parkinson's disease, thereby fostering the development of innovative therapeutic strategies.

Epilepsy is a common chronic brain disorder, with approximately 30% of patients being resistant to conventional anti-epileptic drugs, necessitating precision medicine strategies for individualized treatment. This article systematically reviews the key advances and future directions in the precision treatment of epilepsy, , with its core framework built on three main pillars. First, targeted therapies based on genetic etiology serves as the cornerstone of precision medicine. By using genetic diagnostics to identify pathogenic mutations (such as in SCN1A and KCNQ2), treatment strategies can be tailored with channel modulators, receptor antagonists, or ketogenic diets that address the underlying causes. Second, pharmacogenomics aids in the personalized selection of conventional anti-epileptic drugs by analyzing key genes such as CYP2C9 and HLA-B*15:02, effectively predicting therapeutic efficacy and preventing severe adverse reactions. Third, for drug-resistant epilepsy, precision surgical techniques and neuromodulation methods accurately localize the epileptogenic focus, providing effective intervention options for patients. In the future, integrating multi-omics data, developing of novel targeted therapies, and overcoming clinical translation bottlenecks will be crucial in making precision treatments accessible to a broader patient population.

Hereditary epilepsy refers to a type of epilepsy in which seizures are directly triggered by genetic defects and constitute the core clinical manifestation of the disease. In recent years, with the rapid advancement of gene detection technologies, the genetic mechanisms associated with epilepsy have been progressively elucidated, thereby driving progress in the precision diagnosis and treatment of the condition. Genetic testing has become a crucial tool for the clinical diagnosis and management of hereditary epilepsy. Based on in-depth analysis of specific gene mutations and pathogenic mechanisms, more targeted individualized treatment plans can be developed for patients. This article aims to focus on the etiological classification of hereditary epilepsy and the latest research advances in its precision diagnosis and treatment. Overall, the prospects for precision medicine in hereditary epilepsy are promising. Moving forward, continued multidisciplinary collaboration and sustained efforts are needed to further integrate genetics into clinical practice for epilepsy.

Migraine, with its high prevalence, ranks as the second leading cause of disability among neurological disorders. Chronic migraine, in particular, imposes a greater disease burden, leads to poorer quality of life for patients, and results in higher healthcare resource consumption. Current conventional oral preventive medications often suffer from inadequate efficacy, poor tolerability, and potential drug-drug interactions, which can contribute to the persistence of headaches. This makes chronic migraine a significant clinical challenge and public health issue. Botulinum toxin type A injection has gained widespread attention as an effective preventive treatment for chronic migraine. This expert consensus is developed based on domestic and international advances in diagnosis and treatment, combined with the actual situation in China, with the aim of guiding neurologists and other relevant clinicians in the standardized use of botulinum toxin type A for the management of chronic migraine.

Vascular dementia (VaD), as the second most prevalent type of dementia after Alzheimer's disease, seriously affects the quality of life of patients. Although VaD is theoretically reversible, there is currently no definitive treatment available. Traditional Chinese Medicine (TCM) has been widely employed in VaD management due to its distinct advantages of proven efficacy, minimal adverse effects, cost-effectiveness, and multi-target intervention. The integration of TCM with modern medical approaches can better serve clinical practices. This article systematically reviews the main research advances in VaD over the past decade from both clinical treatment and basic research perspectives. It covers the current mainstream clinical interventions for VaD, along with exploratory findings regarding the mechanisms and potential targets of TCM in VaD treatment. Furthermore, considering the current trends in scientific and technological advancements, we provide insights and prospects on future research avenues and therapeutic development for VaD.

Epilepsy is a chronic neurological disorder often complicated by drug resistance and comorbidities, with limited benefits from conventional therapies. This review explores the role of neuro-immune interactions in epilepsy, detailing a core mechanism where seizures disrupt the blood-brain barrier, enabling immune cell infiltration and activating glial cells to release pro-inflammatory factors, thus perpetuating a vicious cycle. Key signaling pathways are also discussed. The article surveys diagnostic advances, including neuro-immune biomarkers and technologies like multimodal imaging and single-cell sequencing. For treatment, immunomodulatory strategies—such as targeting inflammation, modulating glial cells or gut microbiota, and cell therapies—as well as the development of novel anti-seizure medications​ are summarized. Current challenges involve controversies over immune cell functions and inflammatory causality, as well as limitations in animal models and clinical translation. Future directions like multi-omics integration, artificial intelligence, and novel delivery systems are highlighted, offering a new paradigm for precise, etiology-targeted therapy in drug-resistant epilepsy.

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.

Post-stroke depression (PSD) is one of the most common neuropsychiatric complications following stroke, with a high incidence rate. Depressive states inhibit the secretion of brain-derived neurotrophic factors and hinder neural repair. Early identification and intervention of PSD are crucial for patients' functional recovery, quality of life, and prognosis. Antidepressants can significantly improve depressive symptoms, and early use of antidepressants can also improve patients' motor and cognitive functions. Combining pharmacotherapy with exercise therapy and occupational therapy can enhance the effectiveness of drug treatment. Early intervention for PSD can correct patients' negative cognition towards post-stroke dysfunction, reduce the risk of depressive relapse, and avoid long-term psychosocial impairment.

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.

Multiple system atrophy (MSA) is a rare neurodegenerative disorder with very low incidence and prevalence worldwide. Clinically, it presents as a heterogeneous combination of autonomic failure, Parkinsonism and cerebellar ataxia. This review synthesizes current evidence on the epidemiology, subtype distribution, natural history and prognostic modifiers of MSA, with particular emphasis on the prodromal phase (e.g., rapid eye movement sleep behavior disorder and pure autonomic failure), hallmark clinical milestones after diagnosis (e.g., recurrent falls, wheelchair dependence, dysphagia, and inspiratory stridor), and key determinants of disease progression (including age at onset, severity of autonomic involvement, motor subtype and levodopa responsiveness). The clinical features and prognostic contrasts between young-onset and late-onset MSA are examined, and the future priorities focusing on biomarker development, early diagnosis and prodromal detection, and optimization of multidisciplinary care strategies are highlighted, aiming to inform clinical practice and interventional research.

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.

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.

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 (\overline{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.

Vascular cognitive impairment (VCI) is the second most common type of cognitive disorder in the elderly population, ranking only after Alzheimer's disease, with its clinical spectrum encompassing the entire progression from mild cognitive impairment to vascular dementia. Inflammaging, a prevalent low-grade chronic inflammatory state during aging, is closely associated with various age-related diseases, and has been confirmed to play a pivotal role in the occurrence and progression of VCI. The neurovascular unit (NVU), a core structure for maintaining normal brain function, consists of neurons, glial cells, vascular endothelial cells, pericytes, and the basement membrane. Through a complex intercellular signaling network, the NVU collaboratively regulates cerebral blood flow, maintains blood-brain barrier integrity, and provides the metabolic support for neuronal activity. This review focuses on the NVU to systematically elucidate the mechanisms by which inflammaging contributes to the development of VCI, aiming to reveal the intrinsic relationship between inflammaging and VCI from an inflammatory perspective and provide a theoretical basis for a deeper understanding of the pathophysiological processes of VCI.

The incidence of upper limb and hand dysfunction after stroke is as high as 85%, severely impacting patients' quality of life. Traditional rehabilitation therapies have limited efficacy in some patients, making the exploration of novel rehabilitation techniques a research hotspot. Brain-computer interface (BCI), by decoding motor intention and providing real-time feedback, offers a new approach to inducing neuroplasticity and promoting motor function reconstruction. This article systematically reviews the clinical application progress, mechanisms of action, main paradigms, efficacy assessment, influencing factors, and future directions of BCI in upper limb motor rehabilitation after stroke. With the evolution of technology towards intelligence, the accumulation of high-level evidence, and the construction of a multimodal neural rehabilitation ecosystem, BCI is expected to grow from a cutting-edge technology into a reliable and transformative tool in neural rehabilitation therapy.

This article reports a case diagnosed as hepatolenticular degeneration, with cranial MRI images suggesting the "face of the panda cub" in the pontine tegmentum. By reviewing the discovery process and pathophysiological mechanisms of numerous special neuroimaging signs of hepatolenticular degeneration, we trend to explore the special imaging diagnosis and differential diagnosis of hepatolenticular degeneration.

Movement disorders are one of common neurological complications following solid organ transplantation. They encompass various clinical manifestations, including tremor, myoclonus, and chorea, which significantly impact patients' quality of life. Neurological complications following solid organ transplantation are generally observed at a relatively high overall incidence, with variations across different types of organ transplants. Among these, neurological complications are relatively more common after liver transplantation, which is associated with multiple factors such as hepatic encephalopathy. Although the underlying mechanisms remain incompletely understood, these complications are thought to arise from neurotoxicity from immunosuppressive drugs, metabolic disturbances, and surgical factors. Post-transplant movement disorders often coexist with multiple symptoms, necessitating an active search for underlying causes, ruling out possibilities such as ischemic-hypoxic encephalopathy, infection, or stroke. If movement disorders occur in isolation, the neurotoxicity of medications, such as immunosuppressive agents, should be considered first. Treatment involves etiological management (optimizing the immunosuppressive regimen) and symptomatic therapy (such as antiepileptic drugs, clonazepam, or botulinum toxin injections). With timely intervention, most cases achieve favorable outcomes with a good prognosis. This review focuses on the epidemiology, clinical manifestations, associated symptoms, diagnosis and differential diagnosis, treatment, and prognosis of involuntary movements following liver, kidney, and heart transplantation, aiming to serve as a clinical reference.

Objective： To evaluate the effects of botulinum toxin type A (BTX-A) injection combined with serial plaster casting on fine motor function and upper limb spasticity in children with spastic cerebral palsy (CP).

Methods： A total of 119 children with CP were stratified according to clinical subtype and Manual Ability Classification System (MACS) level, and then randomly divided into an experimental group (n=61) and a control group (n=58) using a random number table. The control group received a single BTX-A injection combined with conventional upper limb rehabilitation training and guidance. The experimental group received additional serial plaster casting. Therapeutic effects were assessed using the Fine Motor Function Measure (FMFM) and the Modified Tardieu Scale (MTS), which assessed spasticity using parameter X, before BTX-A injection, at 1 month, and at 3 months after injection.

Results： At 1 month after treatment, FMFM scores and MTS parameter X scores significantly improved in both groups (P < 0.05), with the experimental group showing superior outcomes compared to the control group (P < 0.05). At 3 months, all scores in the experimental group remained improved despite a slight decrease, while in the control group, all indicators except for elbow extension showed no statistically significant difference compared to those at 1 month post-treatment.

Conclusion： BTX-A combined with conventional upper limb rehabilitation training can significantly improve upper limb muscle spasticity and large-joint motor function in children with CP. The addition of serial plaster casting helps to further enhance hand function and prolong the therapeutic effect.

Objective: To investigate the neurological clinical manifestations, diagnosis, and key treatment strategies of acute intermittent porphyria (AIP), with the aim of improving early recognition and standardized management of the disease.

Methods: The clinical data of a patient who presented with abdominal pain and seizures at disease onset was reported, and a literature review regarding the clinical features, pathogenesis, diagnosis, differential diagnosis, and treatment of AIP was conducted.

Results: The patient successively developed acute abdominal pain, epileptic seizures, and predominantly proximal motor axonal neuropathy. Urinary porphobilinogen (PBG) levels were significantly elevated, and genetic testing revealed a heterozygous mutation in the hydroxymethylbilane synthase (HMBS) gene.

Conclusion: The neurological manifestations of AIP exhibited a characteristic temporal pattern of evolution, and urinary PBG screening is crucial for early diagnosis. Early initiation of hemin therapy is essential to halt disease progression and improve clinical outcomes.

Objective: To evaluate the effectiveness of integrating the evidence-based medicine (EBM) PICOS framework with case-based learning (CBL) in the teaching of neurorehabilitation.

Methods: A total of 100 third-year undergraduates majoring in rehabilitation therapy at Changsha Medical University (Class of 2021) were randomly assigned into two groups through stratified randomization: a reform group and a control group, with 50 students in each. In the neurorehabilitation course, the control group received traditional teaching methods (lecture-based learning), while the reform group was taught using the EBM-PICOS framework combined with CBL. After course completion, teaching effectiveness was compared between the two groups across three dimensions: academic performance, learning outcomes, and clinical internship adaptability.

Results: Compared with the control group, the reform group demonstrated statistically significant improvements in academic performance and clinical internship adaptation scores (P<0.05). The reform group also showed superior learning outcomes in seven aspects: learning engagement, self-directed learning competency, evidence-based practice proficiency, literature retrieval skills, clinical reasoning ability, applied knowledge integration, and professional identity (all P<0.05). However, no statistically significant difference was observed in medical ethics and professionalism between the two groups (P>0.05).

Conclusion: The integration of the EBM-PICOS framework with CBL enhances teaching effectiveness in neurorehabilitation and effectively cultivates rehabilitation competency among rehabilitation therapy students.

Objective: To investigate the clinical value of three vertigo scales in the diagnosis of benign paroxysmal positional vertigo (BPPV) in the community.

Methods: Patients with dizziness and (or) vertigo as the main complaint, who were referred from the Xinhua Sub-district Community Health Service Center of Changning District to Renhe Hospital of Baoshan District, Shanghai, between January 2023 and June 2024, were selected. Patients were grouped based on whether they were diagnosed with BPPV. Before diagnosis, screening was conducted using the Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS) and Vertigo Symptom Scale-Chinese (VSS-C), and the results of the scale evaluations were recorded. A multivariate logistic regression model was used to analyze the factors related to BPPV, and the clinical values of DHI, BBS, VSS-C and the combined application of the three scales in supporting diagnosis of BPPV were analyzed.

Results: A total of 80 patients were included, of whom 36 were diagnosed with BPPV. The DHI and VSS-C scores in the BPPV group were significantly higher than those in the non-BPPV group (P＜0.05), while the BBS score was lower than that in the non-BPPV group (P＜0.05). Multivariate logistic regression analysis showed that DHI score [odds ratio (OR)＝4.440, 95% confidence interval (CI): 1.820-10.831, P＝0.001], VSS-C score (OR＝1.036, 95% CI: 1.009-1.063, P＝0.008) and BBS score (OR＝0.539, 95% CI: 0.298-0.973, P＝0.040) were independent influencing factors for BPPV. ROC curves for DHI score, BBS score, VSS-C score, and the combined application of the three scales showed that the combined application of the three scales had the optimal diagnostic efficacy for BPPV, with a sensitivity of 0.834 and a specificity of 0.779.

Conclusion: The combined application of DHI, BBS and VSS-C scales is helpful for the initial screening of patients with acute vertigo, improves the efficiency of BPPV identification, and enables patients to receive timely diagnosis and treatment.

Alzheimer's Disease (AD) is often accompanied by various neuropsychiatric symptoms, among which depressive symptoms are particularly common and may even appear in the preclinical stage. This paper systematically reviews the complex relationship between depressive symptoms (including subsyndromal symptomatic depression) and AD-related cognitive impairment, with a focus on the potential role of AD-characteristic brain regions such as the hippocampus. Current evidences have suggested that depressive symptoms may accelerate the progression of cognitive decline through various pathways, such as promoting brain atrophy of key brain regions, affecting neuroplasticity, and exacerbating the deposition of amyloid β-protein (Aβ). Future research should further integrate multimodal neuroimaging techniques with non-invasive biomarkers, in order to provide new theoretical basis and clinical targets for early identification and precise intervention of AD in high-risk populations.

Social cognition is a core ability that enables individuals to recognize others' emotions and intentions and relies on a highly coordinated social brain network (SBN), which includes key brain regions such as the fusiform gyrus, amygdala, and medial prefrontal cortex. As a network disorder, epilepsy not only causes seizure manifestations but also disrupts the structure and function of the SBN through direct involvement of epileptogenic foci or the remote propagation of abnormal discharges, leading to social cognitive impairments such as difficulties in emotion recognition, deficits in theory of mind, impaired empathy, and abnormalities in social decision-making. Children and adolescents with epilepsy are particularly vulnerable to deviations in social cognitive development because their brain networks are still undergoing maturation. This review systematically elaborates on the neural underpinnings and clinical manifestations of the SBN in epilepsy, as well as its developmental characteristics in children and adolescents, and proposes a clinically translatable pathway from assessment to intervention. Furthermore, it emphasizes the integration of neuroimaging, neuropsychological assessment, and multimodal rehabilitation strategies to promote a paradigm shift in epilepsy management from seizure control to the improvement of social functioning.

Objective: To observe the clinical efficacy of fire needle therapy in treating symptoms of bulbar paralysis such as dysphagia in patients with amyotrophic lateral sclerosis (ALS).

Method: The study included 56 ALS patients with bulbar palsy symptoms such as dysphagia from June 2020 to December 2024, who were randomly divided into a fire acupuncture group and conventional acupuncture group. Based on modern medical treatment, the fire acupuncture group received sublingual three-needle fire acupuncture therapy, while the conventional acupuncture group received conventional acupuncture therapy, with an 8-week treatment period. Fire acupuncture points selected were Lianquan (tongue I acupuncture) and bilateral points 0.8 cun lateral to Lianquan (tongue II and III acupuncture). Efficacy was evaluated using the Water Swallowing Test, Fujimura Swallowing Function Scoring Standard, Amyotrophic Lateral Sclerosis Symptom Score in Integrative Treatments (ALS-SSIT) oropharyngeal function score, modified Amyotrophic Lateral Sclerosis Symptom Functional Rating Scale (ALSFRS-R) and Drooling Severity and Frequency Scale (DSFS).

Results: Fifty-six patients were enrolled, 5 patients dropped out, and 51 patients were finally included in the statistical analysis (26 cases in the fire acupuncture group, 25 cases in the conventional acupuncture group). At the 8th week of treatment, the proportion of patients with mild symptoms according to the Water Swallowing Test in the fire acupuncture group increased compared to before treatment, and the difference was statistically significant (P<0.05). After 8 weeks of treatment, Fujimura Swallowing Function score, ALS-SSIT oropharynx function score and DSFS score in the fire acupuncture group were significantly better than those before treatment (P<0.05), and were significantly better than those after treatment in the conventional acupuncture group (P<0.05). The ALSFRS-R score of the fire acupuncture group after treatment was also significantly better than that of the conventional acupuncture group (P<0.05).

Conclusion: Compared with conventional acupuncture, fire acupuncture can significantly improve the dysphagia and salivation symptoms of ALS patients, and can delay the disease progress to a certain extent. Fire acupuncture may serve as an adjuvant treatment for ALS patients with symptoms of medullary paralysis such as swallowing difficulties and drooling.

Objectives： Parkinson’s disease (PD) is a neurodegenerative disorder affecting multiple systems. Previous studies have indicated that autonomic dysfunction in PD patients may manifest in the early stages of the disease. This study aims to investigate the correlation between autonomic dysfunction and the progression of motor symptoms in PD patients.

Methods： A total of 738 PD patients participated in this research. The status of autonomic dysfunction was examined by Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction (SCOPA-AUT). And the motor progression was monitored by using Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Besides, neuropsychological status was recorded using Hamilton Depression Scale and Hamilton Anxiety Scale. The participants were followed up for 2 years (±3 months) and the MDS-UPDRS was reassessed to examine the progress in motor function.

Results： The SCOPA-AUT score was significantly correlated with the total MDS-UPDRS score (P＜0.001) as well as the changes in Part Ⅰ (P＝0.005), Part Ⅱ (P＜ 0.001), and Part Ⅲ (P＜0.001) scores (absolute difference between baseline and 2-year follow-up). Among the sub-items of SCOPA-AUT, the scores for autonomic dysfunction related to digestive system, urinary system, cardiovascular symptoms, skin symptoms, and drug use showed significant correlations with the total MDS-UPDRS score and certain sub-scores. However, sexual dysfunction and changes in motor scores did not show significant correlations with the total MDS-UPDRS score or changes in any sub-scores.

Conclusions： Autonomic dysfunction could be considered as a potential predictor of motor progression in PD.

This article reports a case of an elderly female who presented with instability in standing and walking. She had a long-term vegetarian diet and experienced nutritional deficiency in the three months preceding onset. Cervical spinal MRI revealed an "inverted V sign" in the posterior columns. Based on the patient's symptoms, signs, auxiliary examinations, and treatment follow-up results, a final diagnosis of subacute combined degeneration was made. By reviewing the pathophysiological mechanism of the "inverted V sign" as a distinctive imaging manifestation, this article explores the differential diagnostic considerations for this radiological finding.

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder whose rehabilitation requires individualized strategies based on disease subtype and functional impairment. This review systematically summarizes recent advances in the assessment and rehabilitation of respiratory, motor and swallowing dysfunctions in patients with SMA. For respiratory dysfunction, the techniques such as pulmonary function tests, diaphragmatic ultrasound and sleep monitoring, along with interventions including non-invasive ventilation, were evaluated. For motor function, various assessment tools such as functional scales, muscle ultrasound and physical fitness tests were summarized. Additionally, rehabilitation strategies for patients with different motor abilities were analyzed, including strength training, robot-assisted training and neuromodulation techniques. For swallowing function, the assessment methods such as videofluoroscopic swallowing examination, fiberoptic endoscopic evaluation of swallowing and oral pressure measurement, as well as therapeutic approaches including functional training and compensatory strategies, were examined. This review aims to provide an evidence-based framework for rehabilitation and suggests that future research should focus on the clinical translation of multimodal biomarkers and home-based rehabilitation technology to optimize the outcomes and enhance the quality of life.

Standardized residency training is one of the most crucial stages in the continuing education of neurology physicians, closely tied to the professional conduct of physicians. Neurology, a clinical discipline based heavily on substantial theoretical knowledge and multidisciplinary integration, requires the teaching process to not only impart essential professional knowledge and skills but also to focus on developing physicians' professionalism, advanced medical skills, humanistic qualities, and strict adherence to medical ethics. Based on the basic requirements set by the Ministry of Education for the construction of ideological and political courses, we boldly propose a "disease-political education-scenario" three-dimensional case matrix and a "three-dimensional four-step" teaching model. This approach aims to treat clinical scenarios as the third dimension of ideological and political education within courses, thereby enriching and deepening the traditional two-dimensional teaching method, making it more impact and empathetic, and allowing ideological and political education to better integrate into all aspects of neurology teaching. By employing methods such as situational simulations, role-playing, and case discussions, we aim to seamlessly incorporate ideological and political education into the entire neurology teaching process. We hope this three-dimensional case matrix can genuinely enhance residents' ethical sensitivity, communication skills, and clinical decision-making abilities. Furthermore, by learning through cases, the educational function of ideological and political elements in medical professional courses is strengthened.