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temporary rise resulting from the virus infection, or 55.9% (52 cases) showed no decline in immune function
the side-effects of the anti-virus medicine, and offer and no predisposing factors. Therefore, fungal infections
appropriate liver protective medication instead of can also occur in people with normal immune function.
immediately changing the medication. It is not easy to distinguish deep brain-occupying
lesions of granuloma formation from brain tumors and
DIAGNOSIS OF CENTRAL NERVOUS SYSTEM abscesses. Such cases require a diagnostic approach
PARASITIC AND FUNGAL INFECTIONS that combines CSF examination with bacteria and
fungi examination, analysis of pathogens by incubation,
Parasitic infection has regional and seasonal features. and polymerase chain reaction testing. Brain radiation
For example, brain-type lung fluke (infected by eating therapy or excision surgery should not be performed
raw or undercooked crab or crayfish) and Lyme blindly before a clear diagnosis is made, otherwise
disease (infected by tick bite) are more common in the outcome will be misdiagnosis or, even worse, the
the Northern regions of China, while sparganosis spread of fungi. At present, the main treatment for
(infected by playing with or eating frog) and amebic fungal infections is by use of, for example, liposomal
meningoencephalitis (infected by often swimming in amphotericin B, fluconazole and voriconazole, which
a warm, muddy or dead freshwater ditch) are more exhibit greater efficacy, safety and fewer side-effects
common in the Southern regions of China. Hydatid than both amphotericin B and allicin.
disease is more common in the pastoral herders.
At present, neurocysticercosis is relatively rare DIAGNOSIS OF PRION DISEASE
because constantly strengthened pork quarantine and
dramatically improved local health conditions have Creutzfeldt–Jakob disease (CJD) is one type of prion
greatly diminished pork infected by tapeworm. Different disease – a molecular conformational disease caused by
Sc
types of parasitic infections bear their own imaging deposition of abnormal prion protein (PrP ) – in which
characteristics. For instance, the head section and the structure of the normal prion protein PrPc changes,
apparent body wall of a tapeworm could be distinguished in neurons. Prion diseases, also known as “transmissible
clearly in images of cerebral cysticercosis infection, spongiform encephalopathies”, are a class of CNS
and the migration of “tunnel-like” lesions in the brain degenerative encephalopathies that can infect both
parenchyma are visible in images of sparganosis animals and human beings with a long incubation period
infection. All the above parasitic infections could be and a 100% mortality rate. In addition to CJD, human
definitively diagnosed by specific antibody tests. prion diseases include fatal familial insomnia, Kuru
and Gisborne Terman-Strauss syndrome (Gerstmann–
Fungal infection has gradually increased in recent years, Sträussler–Scheinker syndrome). The most common
mainly due to the increase in acquired immunodeficiency human prion disease is sporadic CJD, the incidence of
syndrome (AIDS) infection, transplant surgery and drug which seems to have increased in recent years.
resistance to fungal medication. Certainly, Cryptococcus
neoformans infection is still the most common while The typical symptom triad of CJD is progressive
Aspergillus and Mucor infection of the nervous system dementia, ataxia and myoclonus. Clinical
is relatively uncommon. Fungal infection is generally manifestations can be divided into three stages. The
an opportunistic infection and is not directly related early stage is characterized by weakness, fatigue,
to contact with pigeons (doctors often ask patients, difficulty in concentrating, and memory loss. The
whether they raise pigeons). Cryptococcal fungus also interim stage (dementia-spasticity) is characterized by
exists in the nasal passages of healthy subjects, but is memory disorders, personality changes and dementia,
usually not pathogenic. Cryptococcal infection usually and it can also be associated with aphasia and agnosia.
occurs in subjects with a weakened or deficient immune Two-thirds of patients may exhibit myoclonus, and a
system, such as in those with cancer or AIDS, or series of symptoms may occur successively or alternately
as a result of long-term use of immunosuppressive in this period owing to cortical, extrapyramidal,
agents or hormones. Zhu et al. have reported that pyramidal or cerebellar (alternating or damaged)
[5]
there was no decline in immune function in a patient disease. At the late stage, urinary incontinence,
infected with Aspergillus, in spite of the presence of akinetic mutism or decorticate rigidity arise.
brain-occupying lesions caused by Aspergillus infection. Diagnosis is confirmed by rapid progression of recent
The clinical manifestations of this case resemble those of memory impairment, without symptoms of infection.
another 93 cases reported by Antinori et al., of which Imaging, especially diffusion-weighted imaging and
[6]

10 Neuroimmunol Neuroinflammation | Volume 1 | Issue 1 | June 2014