神经病学教学大纲(供八年制)

神经病学教学大纲(供八年制) Syllabus of Neurology (for 8-year Medical Students) 2008.4 （basic information of this course） 课程名称(name of the course)：神经科学模块2（neuroscience unit 2） 课程号（代码）(code)：502146030 课程类别(type of the course)：（专业与服务课程） 学时(time)：48 学分(score)：3 神经科学模块2是整合了神经病学、神经外科学及精神疾病相关知 识。根据培养目标，通过教与学，使学生能够掌握神经系统疾病学的基 本知识、基础理论和基本技能以及神经系统常见病与多发病的诊断与防 治知识。 在教学中，采用以问题为基础的教学方式，充分发挥教师的主导作 用，由浅入深，重点突出，适当介绍本学科的新进展。充分调动学生的 积极性，独立思考，提倡积极讨论问题，理论联系实际，培养他们的自 学能力及分析解决问题的能力。将神内、神外与精神科相结合，可使学 生掌握知识更加全面。 本大纲按自编讲义内容并参考认知领域和临床技能考试大纲的内 容编写，并提供参考。在教学目的方面用“掌握”、“熟悉”、“了 解”来说明不同程度的学习要求。 Objective and requirements: Neuroscience unit 2 is a combination of neurology, neurosurgery and psychology. All medical students should acquire and maintain some basic knowledge, theories and skills of neuroscience, and master the diagnosis, 1 treatments and prevention of common neurological disorders. In the class, teachers should play a key role, introduce the knowledge step by step with the problem-based model, emphasize the keystones, and present the students with the new improvements on neuroscience. Teachers should enlighten students to think independently, discuss actively and to combine the theories with practice so that they can improve their abilities of self-study and solving problems. The conjunction of neurology, neurosurgery and psychology makes the students more deeply and comprehensively to grasp the knowledge. This syllabus based on self-compiled teaching materials, bombing with the outline of test of clinical skills and knowledge. It uses „master, familiarized with and generally understand? to show the different requirements. 1 * 1 章节 题目 课时 1 总论 4 2 缺血性脑血管病 4 3 出血性脑血管病 4 4 癫痫、帕金森病 4 5 脊髓疾病 4 6 中枢神经系统感染、脑器质性精神障碍、周围神经疾病、肌肉疾病 4 7 神经变性疾病、神经遗传性疾病、脱髓鞘疾病 4 8 头痛、颅内压增高及脑疝 4 9 颅脑外伤、肿瘤 4 合计 36 2 Table 1 Lecturing contents chapter title Time (class) 1 Introduction 4 2 Ischemic Cerebrovascular Diseases 4 3 Hemorrhagic Cerebrovascular Diseases 4 4 Epilepsy , Parkinson?s disease 4 5 Spinal cord diseases 4 6 Infections of CNS, psychology associated 4 due to brain disease, Peripheral Neuropathy, muscular diseases 7 Neurodegeneration and neurogenetic disease, 4 Multiple sclerosis 8 Headache, Intracranial Hypertension and 4 Brain Herniation 9 craniocerebral trauma; brain tumor 4 sum 36 自编讲义 1．MERRITT?S Neurology 2、《实用神经病学》 主编:史玉泉 2003.7. 3、《神经外科手术学》 主编：王忠诚 4、Oxford Textbook of Psychiatry : —————————————————————————————— 备注： 1、 各学院可根据参考格式，结合本学科课程的特点，另行教学大纲的格式，但本学院所开各门课程的 教学大纲必须统一格式。 2、 每门本科课程都必须有教学大纲。 教学大纲的内容要符合培养目标要求，服从课程体系结构及教学安 3 排的整体需要。教学大纲由教研室组织有关教师编写，经学院或教研室认定后施行，并注意根据每轮教 学的具体情况及时更新、修订大纲内容。教师在教学过程中原则上应当严格执行教学大纲。 3、 学院开出的各门本科课程的教学大纲均应上网（学院网页），并在上第一次课时就告诉学生，以便于学 生查询。 Introduction 1、意识障碍的分类 2、运动性、感觉性、命名性及混合性失语 3、感觉、运动系统的定位诊断及感觉障碍与瘫痪的类型 4、脑不同部位损害的临床现 5、脑脊液各项指标的正常值 1、特殊类型的意识障碍及脑死亡 2、视、动眼、三叉、外展、面、舌咽、迷走神经和舌下神经受损 时的主要症状体征，特别是眼肌麻痹的分类与表现 3、常见不自主运动及共济失调类型 4、深、浅及病理反射的临床意义 5、神经系统疾病的病史采集和临床常规检查方法以及与各论中疾 病有关的定位诊断 神经电生理、影像学检查的意义及基因学诊断技术 Objectives After completing of this chapter, you should have achieved the following goals: 1、Master classification of consciousness disorder 4 2、Master the motor aphasia, sensory aphasia, amnesic aphasia and total aphasia 3、Master the topographic diagnosis of motor and sense lesions, types of paralysis and sensory disorders. 4、Master the symptoms and signs of lesions of different part of the brain 5、Master the normal values of cerebral spinal fluid (CSF) inspection 6、Familiar with: special types of conciousness and brain death 7、Familiar with the main manifestations of lesions of optic nerve、 oculomotor nerve、abducent nerve、trigeminal nerve、facial nerve、 glossopharyngeal nerve、vagus nerve and hypoglossal nerve; especially the manifestations of ophthalmoplegia 8、Familiar with the frequent types of involuntary movements and ataxia 9、the clinical importances of superfacial reflexes, deep reflexes and abnormal reflexes 10、Familiar with: The method of history collection and routine clinical examination, relative topographic diagnosis 11、Knowing the electrophysiology, imaging studies, and genetic investigations in neurology 【】 4课时 【lecturing time】 4 class 一、意识障碍的分类及特殊类型的意识障碍、脑死亡 二、常见的失语（运动、感觉及混合性失语）及构音障碍的解剖基 础与临床表现 5 三、视、动眼、滑车、外展、面、舌咽、迷走、舌下等颅神经损害 的主要症状、体征, 核上、下型眼肌麻痹表现 四、感觉系统 1、感觉的分类：特殊感觉、一般感觉、复合感觉 2、深浅感觉的传导通路、主要节段支配 3、感觉障碍的几种类型 4、各种感觉障碍的临床表现和感觉障碍的定位诊断（皮质、内囊、 脑干、脊髓、周围神经损害的特点）。 五、运动系统 1、运动系统包括的范围（随意运动、锥体外系统及小脑系统），随 意运动系统的传导解剖通路 2、随意运动障碍及上、下运动神经元瘫痪的鉴别 3、瘫痪的定位诊断（皮质、内囊、脑干、脊髓及损害表现） 4、锥体外系统运动障碍，不自主运动、肌张力变化 （1）不自主运动：震颤、痉挛、抽搐、舞蹈样动作、手足徐动症及 扭转痉挛 （2）肌张力变化：强直性增高、变型性肌张力障碍、肌张力降低。 5、小脑系统运动障碍：共济失调的临床表现及检查方法 六、反射系统 深、浅反射的改变，病理反射的临床意义，常见几种病理反射 七、大脑、小脑、脑干的解剖及各部位损害的临床特点。 八、辅助检查 1、脑脊液：压力及各项指标正常值、电生理（脑电图、肌电图、 诱发电位）、组织显像（CT、MRI、同位素等）等项检查的临床意义， 组织活检（肌肉、神经、脑）的临床意义。 2、神经电生理、影像学检查的意义及基因学诊断技术（自学） 6 【lecturing contents】 1、Classification of conscious disturbance, special types of conciousness, brain death 2、Manifestation of different aphasia and their localization; the anatomy and manifestation of dysphasia 3、the main manifestations of lesions of: optic nerve、oculomotor nerve、abducent nerve、trigeminal nerve、facial nerve、glossopharyngeal nerve、vagus nerve and hypoglossal nerve; the manifestations of upper and lower motor neuron paralysis of extraocular muscles 4、Sensory system: （1）classification of sensation: special sensation, common sensation, complex sensation （2）the conducting contract pathway of superfacial and deep sensation; mian spreading section （3）classification of sensational disorders （4）manifestation of each kinds of sensation and the topography diagnosis of sensational disturbances (cortex, internal capsule, brain stem, spinal cord, peripheral nerve ) 5、Movement system: （1）Aspect of movement system (voluntary movement, extrapyrimidal system and cerebellar system), the conduct tract pathway of voluntary movement system （2）Disturbances of voluntary movement; differentiation of the upper and the lower motor neuron paralysis （3）topography diagnosis of palsy(cortex, internal capsule, brain stem, spinal cord) （4）Disturbances of extrapyrimidal system; involuntary movement, 7 changing of musclar tone ?Involuntary movement: tremor, spasm, tic, and so on ?Changing of muscular tone: rigidity, and so on （5）Disturbances of cerebellar system: manifestation and examination of ataxia 6、Reflex system Changing of superficial, deep reflex, clinical importance of pathological changes, pathological reflexes found often in clinic 7、The anatomy and the manifestation of lesions of the Cortex、 Cerebellum、Brain stem: anatomy, signs and symptoms 8、Investigative studies: （1）CSF: pressure, normal values. Electrophysiology(EEG, EMG, EP); Tissue imaging(CT, MRI, and so on); Tissue biopsy( muscle, nerve, brain) （2）electrophysiology, imaging studies, and genetic investigations in neurology ( studying by students themselves) Ischemic Cerebrovascular diseases 掌握脑动脉血栓形成和脑栓塞的临床表现、诊断、鉴别诊断和治疗 原则 熟悉短暂性脑缺血发作的概念、特点及治疗措施 1、了解缺血性脑血管疾病的分类，危险因素和预防 8 2、了解腔隙性及分水岭脑梗死的概念，临床特点及治疗措施 3、了解静脉窦血栓形成的定义、病因、分类及诊断与治疗原则 4、了解缺血性脑血管病的外科治疗 Objectives 1、Master: the clinical manifestation, diagnosis, differential diagnosis and treatment principle of cerebral infarction, apoplexy and subarachnoid hemorrhage 2、Familiar with: the conception, manifestation and treatment of transient ischemic attack. 3、Knowing: classification, risk factor and prevention of ischemic cerebrovascular disease. Kowning：conception, cause, ,classification, diagnosisand treatment of cerebral venous thrombosis Knowing: conception, clinical manifestation, treatment of lacunar infarction,cerebral watershed infarction Knowing: the surgical treatment of ischemic cerebrovascular disease 4课时 lecturing time 4 classes 1、脑血管应用解剖 2、缺血性脑血管疾病的分类，危险因素和预防 3、动脉血栓性脑梗死的病因和发病机制、病理、临床表现、诊断 和鉴别诊断、治疗原则 3、脑栓塞的病因和发病机制、病理、临床表现、诊断和鉴别诊断、 治疗原则 9 4、短暂性脑缺血发作的病因、临床特点、诊断、治疗 5、腔隙性脑梗死的定义，病因、临床表现、诊断和治疗 6、分水岭脑梗死的定义，病因、临床表现、诊断和治疗。 7、静脉窦血栓形成的定义、病因、分类及诊断与治疗原则 8、缺血性脑血管病的外科治疗：颈内动脉内膜切除术，恶性大脑 中动脉综合征的外科治疗 lecturing contents 1、Blood supply of the brain 2、Classfication, risk factors and prevention of ischemic cerebrovascular disease 3、The etiology, pathogenesis, clinical manifestation, diagnosis, differential diagnosis and treatment principles of cerebral thrombosis 3、The etiology, clinical manifestation, diagnosis, differential diagnosis and treatment principles of cerebral embolism 4、The etiology, clinical manifestation, diagnosis, and treatment principles of transient ischemic attack. 5、Conception, cause, manifestation, diagnosis and treatment of lacunar infarction 6、Conception, cause, manifestation, diagnosis and treatment of cerebral watershed infarction 7、Conception, cause, manifestation, diagnosis and treatment of cerebral venous thrombosis 8、the surgical treatment of ischemic cerebrovascular disease: Carotid Endarterectomy; the surgical treatment of malignant MCA syndrome . 10 Hemorrhagic Cerebrovascular diseases 1、掌握脑出血和蛛网膜下腔出血的临床表现、诊断、鉴别诊断和 内、外科治疗原则 3、了解出血性脑血管疾病的分类，危险因素和预防 Objectives 1、Master: the clinical manifestation, diagnosis, differential diagnosis and medical and surgical management principle of cerebral hemorrhage and subarachnoid hemorrhage 2、Knowing: The classification, risk factors and prevention of hemorrhagic cerebrovascular diseases 4课时 lecturing time 4 classes 1、出血性脑血管疾病的分类，危险因素和预防 2、脑出血的病因、发病原理、病理、临床表现、诊断和鉴别诊断、 治疗原则、外科手术指征、预防。 3、蛛网膜下腔出血的病因、病理、临床表现、辅助检查、诊断、鉴别诊断和内科及外科治疗原则。 lecturing contents 1、The classification, risk factors and prevention of hemorrhagic cerebrovascular diseases 2、The etiology, pathogenesis, clinical manifestation, diagnosis, differential diagnosis ，treatment principles，the surgical indications and 11 prevention of cerebral hemorrhage 3、The etiology, pathogenesis, clinical manifestation, laboratory investigation, diagnosis, differential diagnosis ，medical and surgical treatment principles of subarachnoid hemorrhage. Epilepsy 1、掌握癫痫的治疗原则与癫痫持续状态的抢救 2、熟悉癫痫的分类、临床表现、诊断、鉴别诊断及外科治疗（手 术指征、术前准备） 3、了解癫痫的病因与发病原理和预防措施 Objectives 1、Master: （1）treatment of epilepsy （2）Emergency rescue of epileptic state 2、Familiar with: the classification, clinical manifestation, diagnosis differential diagnosis and surgical treatment of epilepsy(surgical indication, preoperative preparation) of epilepsy 3、Knowing: etiology, pathogenesis and prevention of epilepsy 【】1+2/3课时 【lecturing time】 1+2/3classes 【】 1、定义 2、病因 3、发病机制：介绍癫痫病灶的异常放电与传播 12 4、分类 5、临床表现：讲解痫性发作各种类型临床表现 6、诊断和鉴别诊断：确诊癫痫依据，脑电图的诊断价值，与假性 发作、TIA、晕厥、偏头痛等的鉴别，症状性癫痫者的病因寻找 7、防治：病因治疗、预防致病因素；痫性发作时的处理，药物治 疗原则，药物副作用 8、癫痫持续状态的处理 9、癫痫外科治疗：手术指征和术前准备 lecturing contents 1、Conception: introduce the conception of epilepsy and epileptic seizure, briefly lecturing the epidemiological character of epilepsy 2、Etiology: introduce primary and secondary epilepsy; localization of epileptic lesion; classification of seizure and the diagnostic method of epilepsy 3、Pathogenesis: introduce the abnormal discharge and conduction of epilepsy 4、Classification of epilepsy 5、Clinical manifestation: explain the manifestation of different kinds of seizure 6、Diagnosis and differential diagnosis: evidences for confirm epilepsy, EEG, different from pseudoepilepsy, TIA, vertigo, migraine. Finding causes of symptomatic epilepsy 7、Prevention and treatment：treatment of causes, prevention of causes, treatment of seizure, principle of how to use antiepileptic drugs, side effects og antiepileptic drugs 8、Treatment of status epilepticus 9. surgical treatment of epilepsy(surgical indication, preoperative 13 preparation) of epilepsy Parkinson’ Disease 1、掌握帕金森病的临床表现 2、熟悉帕金森病的诊断、鉴别诊断、内科及外科治疗方法（深部 脑刺激） 3、了解帕金森病的病因 Objectives 1、Master: the clinical manifestation of Parkinson disease 2、Familiar with: diagnosis，differentiation and medical and surgical treatment (DBS) of Parkinson disease 3、Knowing: etiology of Parkinson disease 【 1+1/3课时 lecturing time 1+1/3 classes 【】 1、帕金森病的病因 2、帕金森病的临床表现症状：震颤、肌强直、运动障碍三大表现 3、诊断与鉴别诊断：与继发性帕金森病综合征，多系统萎缩，肝 豆核变性 4、治疗方法 5、外科立体定向治疗和脑起搏器植入治疗 lecturing contents 1、The etiology of parkinsonism 14 2、The clinical manifestation of Parkinsonism: tremor, rigidity, and dyskinesia 3、Differentiation: distinguish from secondary PD, multiple atrophy and Wilson?s disease 4、Treatment 5、surgical treatment :stereotaxis treatment and DBS Myelopathy compressive myelopathy 掌握压迫性脊髓疾病的临床表现，纵向和横向定位 1、熟悉压迫性脊髓疾病的病因 2、熟悉压迫性脊髓疾病的内外科治疗 Objectives 1、Master: clinical manifestation, transactional longitudinal topographic diagnosis of compressive myelopathy 2、Familiar with etiology of compressive myelopathy 3、Familiar with: the medical and surgical treatment of compressive myelopathy 【】2 课时 【lecturing time】2 class 1、脊髓解剖 15 2、病因：压迫性脊髓疾病的常见病因 3、临床表现：压迫性脊髓疾病的临床表现 4、诊断：压迫性脊髓疾病的横向纵向定位诊断和定性诊断 5、内外科治疗原则 lecturing contents 1、Anatomy of Spinal Cord 2、Etiology: common causes of a compressive myelopathy 3、Clinical symptoms and signs: the manifestation of compressive myelopathy 4、Transactional longitudinal topographic diagnosis 5、The principle of medical and surgical treatment Acute myelitis 掌握急性脊髓炎的临床表现 1、熟悉急性脊髓炎的鉴别诊断 2、熟悉急性脊髓炎治疗 Objectives 1、Master: manifestation of acute myelitis 2、Familiar with differentiation of myelitis. 3、Familiar with: the treatment and nursing of myelitis 【】2学时 【lecturing time】 2 classes 16 1、病因和病理：简述急性脊髓炎的一般病因 2、临床表现：重点讲述脊髓炎的急性休克期、恢复期及并发症的 临床表现 3、诊断：与急性硬膜外脓肿，脊髓出血，脊髓压迫症、视神经脊 髓炎等进行鉴别 4、治疗与护理：急性期治疗及护理；恢复期处理 lecturing contents 1、Etiology and pathology: Introduce the general causes of acute myelitis 2、Clinical symptoms and signs: Lecture the manifestation of acute myelitis in spinal shock and complexes 3、Diagnosis and differentiation including spinal epidural abscess, spinal hemorrhage, compressive spinal diseases, optic myopathy 4、Treatment and nursing Infection of CNS 1、掌握单疱病毒性脑炎的病因、临床表现、诊断及鉴别诊断 2、熟悉辅助检查方法和治疗原则 3、了解CNS感染的分类和生物源性感染源 Objectives 1、Master: the cause, manifestation, diagnosis and differential diagnosis of herpes simplex virus encephalitis. 17 2、Familiar with: the methods of investigation and treatment. 3、Understanding of: category of central nervous system infection and infectious origin. 【】1课时 lecturing time 1 class 1、简介中枢神经系统感染的定义 2、简介CNS感染的生物源感染原 3、简介感染途径，血行、直接感染、经神经干感染 4、单疱病毒脑炎（herpes simplex encephalitis，HSE） （1）病因 （2）病理改变：颞叶，额叶脑组织水肿、软化、出血性坏死 （3）临床表现 （4）实验室检查：脑脊液、脑电图、MRI、活检, 病原学检测 （5）诊断及鉴别诊断 （6）治疗原则 lecturing contents 1、Introduce briefly the conception of central nervous system infection 2、Introduce briefly the biological infectious origin of central nervous system infection 3、Introduce briefly pathway of central nervous system infection 4、HSE （1）Etiology （2）Pathology （3）The clinical manifestation of herpes simplex virus encephalitis （4）Investigation: CSF, EEG, MRI, biopsy, investigative studies for 18 infectious origin （5）Diagnostic and differential diagnosis of HSE （6）Treatment of HSE (Mental Disorders due to brain diseases) 1 2 3 Objectives 1、master the definition of mental disorders due to brain diseases and the principals of diagnosis and treatment. 2、master the definition of delirium . 3、Familiar with the pathological mechanism of delirium. 【】 1学时 【lecturing time】 1 class 1、脑器质性精神障碍的概念 2、脑器质性精神障碍的常见症状和综合征 3、脑器质性精神障碍的诊治原则 4、谵妄的概念 5、谵妄的病理机理 【lecturing contents】 1、The concepts of mental disorders due to brain diseases 2、The common syndromes and their symptoms of mental disorders due 19 to brain diseases 3、the principals of diagnosis and treatment of mental disorders due to brain diseases 4、The conception of delirium 5、The pathological mechanism of delirium Peripheral Neuropathy Guillain-Barre’, GBS 掌握急性炎症性脱髓鞘性多发性神经病的临床表现及诊断 熟悉急性炎症性脱髓鞘性多发性神经病的鉴别诊断和治疗原则 Objectives 1、Master: the clinical manifestation and diagnosis of Gullain-Barre? syndrome 2、Familiar with: the differential diagnosis and treatment principles of Gullain-Barre? syndrome 【】 30分钟 【lecturing time】 30 min 1、病因：多种原因引起的自身免疫性疾病 2、病理：神经根、神经节、周围神经的主要病理改变是髓鞘脱失 20 3、临床表现：急性或亚急性发作；对称性四肢周围性瘫痪；未梢 型感觉障碍；可伴有颅神经麻痹、电生理检查、脑脊液内的蛋白细胞分 离现象，呼吸肌麻痹是主要死因 4、诊断和鉴别诊断：本病主要与急性脊髓炎、急性脊髓灰质炎、 周期性麻痹鉴别 5、治疗：：?对症治疗、瘫痪（包括球麻痹和呼吸肌麻痹）的治疗。 ?病因治疗：免疫球蛋白、血浆置换 【lecturing contents】 1、Etiology: autoimmune mediated 2、Pathology: 3、Clinical manifestation: supranuclear paralysis of four limbs, distal sensory impairment, cranial nerve palsy, separation of CSF protein and leucocytes, decreased nerve conduction velocity 4、Diagnosis and differentiation: differential diagnosis with low potassium periodic paralysis, myasthenia gravis and acute myelitis 5、Treatment: ? symptomatic treatment; ?etiologic treatment: plasma exchange, immunoglobulin injection of vein <> Idiopathic facial palsy 掌握特发性面神经麻痹的临床表现 熟悉治疗方法 Objectives 21 1、Master the clinical manifestation of idiopathic facial palsy 2、Familiar with the treatment of idiopathic facial palsy 10分钟 lecturing time 10 min 1、病因：未完全明确 2、临床表现：急性起病，呈单侧面神经周围性麻痹的症状和体征 3、诊断：与其它原因引起的面神经麻痹 4、治疗：急性期短期用?皮质类固醇?神经营养药物进行治疗? 针灸、理疗?眼的护理 【lecturing contents】 1、Etiology 2、Clinical manifestation: symptoms and signs of unilateral peripheral facial palsy (Bell?s palsy) 3、Diagnosis: differential diagnosis with supranuclear facial paralysis and those due to other reasons 4、Treatment: ?corticosteroids ?vitamin B and B in acute phase; 12 ?facial muscle training and physiotherapy? nursing care on the eyes Trigeminal nerve disease 1、熟悉三叉神经痛的临床表现 2、熟悉三叉神经痛的治疗方法 【Objectives】 22 1、Familiar with: the clinical manifestation of trigeminal neuralgia 2、Familiar with: the therapy of trigeminal neuralgia 5 【lecturing time】 5 min 1、病因：原发性三叉神经痛的病原尚未完全明确 2、临床表现： ?疼痛的部位：二、三支 ?疼痛的特点：性质、时间、反复 ?扳机点 ?间歇期正常无体征 3、诊断： ?诊断要点 ?与症状性三叉神经痛相鉴别。 4、治疗：?药物：卡马西平、B12、鞍莫钠；?封闭：无水酒精注射；?射频热凝；?手术治疗，首选药物为卡马西平 【lecturing contents】 1、Etiology: not completely clear 2、Manifestation: repeated paroxysm of intense, stabbing pain in the distribution of mandibular and maxillary divisions of the trigeminal nerve 3、Diagnosis: differential diagnosis with the symptomatic trigeminal neuralgia 4、Treatment: ?medicine therapy: cabamazepine, large dose of vitamine B , phenytoin sodium; ?nerve blocking or surgery: 12 ?stereotactically controlled thermocogulatin of trigeminal roots using a radio-frequency generator; microvascular decompression 23 - Myasthenia Gravis 掌握重症肌无力的临床表现 1、熟悉重症肌无力危象的分类与诊断 2、熟悉重症肌无力的处理 Objectives 1、Master: the clinical manifestation of myasthenia gravis 2、Familiar with: types and diagnosis of myasthenia gravis crisis 3、Familiar with: the treatment of myasthenia gravis 【】 30 lecturing time30 min 】 1、简述重症肌无力的病因，发病原理 2、临床表现： 临床特征——肌易疲劳性、症状波动性，三种危象的原因及鉴别要 点 3、诊断与鉴别诊断： 诊断的主要依据：肌易疲劳的临床表现，疲劳试验阳性，药物试验， 阳性肌电检查及AchR抗体滴度测定，是否有胸腺瘤，甲状腺机能亢进 等疾病。并须与Lambert-Eaton综合征等病鉴别。肌无力危象的分类与 诊断 24 4、治疗： 抗胆硷酯酶药物、皮质类固醇，免疫抑制剂治疗、胸腺手术、危象 处理 lecturing contents 1、Briefly introduce etiology and pathogenesis of myasthenia gravis 2、Clinical manifestation 3、Diagnosis and differential diagnosis of myasthenia gravis 4、Treatment of myasthenia gravis Familial periodic paralysis 掌握周期性瘫痪的临床表现及低血钾型周期性瘫痪的治疗 熟悉周期性瘫痪的鉴别诊断 Objectives 1、Familiar with: the clinical manifestation and treatment of periodic paralysis 2、Familiar with: the differential diagnosis of periodic paralysis 】15 lecturing time15 min 【】 1、简述周期性瘫痪的病因及发病机制 2、低钾型周期性瘫痪的临床表现 25 3、各型周期性瘫痪的鉴别诊断 4、低钾型周期性瘫痪的治疗 lecturing contents 1、Introduce briefly etiology and pathogenesis of periodic paralysis 2、Clinical manifestation of periodic paralysis 3、Differential diagnosis on various types of periodic myasthenia 4、Treatment of periodic paralysis Neurological Degenerative and Hereditary Diseases Motor Neuron Disease, MND 1、熟悉肌萎缩侧索硬化的诊断 2、熟悉肌萎缩侧索硬化临床表现 3、了解运动神经元病的辅助检查 4、了解运动神经元病的鉴别诊断和治疗原则 Objectives 1、Familiar with: diagnostic criterion of ALS 2、Familiar with: clinical manifestation of ALS 3、Knowing: investigative examination of MND 4、Knowing: differentiation and treatment of MND 】 1课时 26 lecturing time 1 classes 【】 1、简介运动神经元病的定义、发病情况 2、运动神经元病病因和发病机制 3、运动神经元的病理：运动皮质的大锥体细胞消失，脊髓前角和 脑干的运动神经元脱失 4、临床表现：年龄、性别特点、起病形式及病程特点 5、辅助检查措施 6、诊断和鉴别诊断：介绍诊断标准；需要鉴别的疾病介绍 7、病程与预后 8、运动神经元病治疗现状 lecturing contents 1、The Conception, etiology of motor neuron disease. 2、The Etiology and pathogenesis of motor neuron disease 3、The Pathology of amyotrophic lateral sclerosis 4、The clinical manifestation of amyotrophic lateral sclerosis 5、The investigative exam in motor neuron disease. 6、Differentiation: distinguish from other disease 7、The Course and prognosis of amyotrophic lateral sclerosis 8、Current status of treatment Alzheimer Disease, AD 掌握阿尔茨海默病的临床表现及诊断 27 1、了解阿尔茨海默病的诊断标准及治疗方法 2、了解阿尔茨海默病的病理 Objectives 1、Master: clinical manifestation and diagnosis of AD 2、Knowing: diagnostic criterion and treatment of AD 3、Knowing: pathogenesis of AD 】 1课时 lecturing time 1 classes 【】 1、简介阿尔茨海默病的病因研究。 2、阿尔茨海默病的临床表现。 3、阿尔茨海默病诊断及鉴别诊断 4、阿尔茨海默病的治疗方法 lecturing contents 1、Introduce briefly etiology and pathogenesis of Alzheimer disease. 2、Clinical manifestation of Alzheimer disease. 3、Differential diagnosis on Alzheimer disease 4、Treatment of Alzheimer disease Hereditary Ataxia and Hereditary Spastic ParaplegiaHSP 1、熟悉脊髓小脑性和Friedreich共济失调的临床表现 28 2、熟悉遗传性痉挛性截瘫的临床表现 了解遗传性共济失调的分型 Objectives 1、Familiar with: clinical manifestation of SCA and Friedreich ataxia 2、Familiar with: clinical manifestation of HSP 3、Knowing: type of hereditary ataxia 】 1课时 lecturing time 1 classes 【】 1、简介遗传性共济失调研究。 2、脊髓小脑性和Friedreich共济失调的临床表现 3、遗传性痉挛性截瘫的临床表现 lecturing contents 1、Introduce briefly etiology and pathogenesis of hereditary ataxia. 2、Clinical manifestation of SCA and Friedreich ataxia 3、Clinical manifestation of hereditary spastic paraplegia Multiple sclerosis 1、熟悉多发性硬化的诊断标准 2、熟悉M.S的临床表现 29 1、了解M.S的常用辅助检查 2、了解多发性硬化的鉴别诊断和治疗 Objectives 1、Familiar with diagnostic criteria of multiple sclerosis 2、Familiar with manifestation of multiple sclerosis 3、Understanding of investigative studies used normally 4、Understanding of: differential diagnosis and treatment of multiple sclerosis 1 课时 lecturing time 1 class 【】 1、定义、发病机制及病理 2、临床表现，临床分型 3、诊断和鉴别诊断 诊断标准包括临床和实验确诊，脑脊液，诱发电位，MS表现 4、治疗原则：激素、其他免疫疗法、支持、对症、避免促发因素 lecturing contents 1、Conception, pathogenesis and pathology of multiple sclerosis 2、Clinical manifestation and classification of multiple sclerosis 3、Diagnosis and differential diagnosis Diagnostic criteria include clinical manifestation and laboratory exam, SCF, EP, and MRI 4、Treatment principle: corticosteroid, other immune therapy, supporting therapy, and treatment according to symptoms 30 (Headache, Intracranial Hypertension and Brain Herniation) (Classification of Headache) 了解头痛的分类 Objectives 1、Knowing of classification of headache 1/3课时 lecturing time 1/3 class 1、简介头痛的国际分类 lecturing contents 1、 Introduce briefly the international classification of headache Migraine 1、熟悉偏头痛的诊断 2、熟悉偏头痛治疗与预防 31 了解偏头痛的类型 Objectives 1、Familiar with diagnosis of migraine 2、Familiar with treatment and prevention of migraine 3、Knowing of types of migraine 1课时 lecturing time 1 class 1、简介偏头痛的定义与病因 2、偏头痛的临床表现与分类，重点介绍典型型偏头痛的表现 3、偏头痛的诊断 4、偏头痛的鉴别诊断，注意与占位病变，其它血管性头痛鉴别 5、偏头痛的治疗与预防 lecturing contents 1、Introduce briefly the conception and etiology of migraine 2、Clinical manifestation and classification. Pay attention to the symptoms and signs of typical migraine 3、The diagnosis of migraine 4、The differentiation of migraine. Care for the differences from another vascular headache 5、The treatment and prevention of migraine Tension Headache 1、了解紧张型头痛的诊断 32 2、了解紧张型头痛治疗与预防 Objectives 1、Knowing of diagnosis of tension headache 2、Knowing of treatment and prevention of tension headache 2/3课时 lecturing time 2/3 class 1、简介紧张型头痛的定义与病因 2、紧张型头痛的临床特点 3、紧张型头痛的诊断、鉴别诊断 4、紧张型头痛的治疗与预防 lecturing contents 1、Introduce briefly the conception and etiology of tension headache 2、Clinical features of tension headache 3、The diagnosis and discrimination of tension headache 4、The treatment and prevention of migrain (Intracranial Hypertension and Brain Herniation 1、掌握颅内压增高的临床表现、脑疝的病理、诊断和处理； 2、熟悉颅内压增高的病理生理； 3、了解颅内压增高的病因及影响因素。 Objectives 1、Master: the clinical manifestation of intracranial hypertension; the pathology ,diagnosis and treatment of brain herniation. 33 2、Familiar with: the pathophysiology of intracranial hypertension; 3、Knowing: the etiology and influential factors of intracranial hypertension. 2课时 lecturing time 2 classes 【教学内容】 1、正常颅内压及调节； 2、颅内压增高的病因、影响因素及病理生理； 3、颅内压增高的临床表现； 4、颅内压增高的诊断和处理； 5、脑疝的病理、诊断和处理。 【lecturing contents】 1、Intracranial pressure and it?s regulation 2、The etiology、influential factors and pathophysiology of Intracranial Hypertension 3、The clinical manifestation of Intracranial Hypertension 4、The diagnosis and treatment of Intracranial Hypertension 5、The pathology、diagnosis and treatment of brain herniation Craniocerebral Injury 1、掌握颅伤（头皮、颅骨损伤）的诊断、处理 2、掌握各型颅内血肿的共同特点（脑受压），硬膜外、硬膜下和脑 内血肿的特点、诊断和治疗原则； 34 3、熟悉闭合性原发性脑伤的特点，脑震荡、脑挫伤、弥漫性轴索 损伤和原发性脑干损伤的诊断和治疗。 Objectives 1、To master the diagnosis and treatment of scalp and skull injury 2、Master: the clinical feature 、diagnosis and treatment of epidural hematoma and subdural hematoma and intracerebral hematoma ; 3、Familiar with the clinical feature of primary brain injury, the diagnosis and treatment of concussion、contusion and DAI. 3 课时 lecturing time 3 classes 【】 1、闭合性原发性脑损伤（脑震荡、脑挫裂伤、弥漫性轴索损伤和 原发性脑干损伤）的诊断和处理； 2、硬膜外、硬膜下、颅内血肿的临床特点、诊断和治疗原则； 3、脑损伤的机制； 4、颅骨骨折的诊断和处理，重点是颅底骨折； 5、头皮损伤，重点是头皮血肿； 6、开放性颅脑损伤的特点及处理原则 lecturing contents 1、diagnosis and treatment of primary brain injury; 2、the clinical feature 、diagnosis and treatment of epidural hematoma and subdural hematoma and intracerebral hematoma; 3、the mechanism of brain injury; 4、the diagnosis and treatment of skull fracture; 5、scalp injury 6、the feature and treatment of open brain injury 35 Intracranial Tumors 1、掌握脑胶质瘤、脑膜瘤、垂体瘤、听神经瘤、颅咽管瘤和血管 网状细胞瘤的临床特点； 2、熟悉常见颅内肿瘤的分类及临床表现； 3、了解颅内肿瘤的诊断、治疗原则。了解椎管内肿瘤的分类、临 床表现、诊断和治疗。 Objectives 1、Master: the clinical features of neurogliocytoma 、meningioma 、 pituitary tumor、acoustic neuroma、craniopharyngioma 、angioreticuloma; 2、Familiar with the clinical features and classification of intracranial tumors; 3、Knowing: diagnosis、treatment of intracranial tumor. The classification 、clinical features、diagnosis and treatment of tumors in vertebral canal. 1 课时 lecturing time 1 class 【】 1、介绍颅内肿瘤的概括（病因、分类、发病部位等）； 2、脑胶质瘤、脑膜瘤、垂体瘤、听神经瘤、颅咽管瘤和血管网状 细胞瘤的临床特点和诊断； 3、颅内肿瘤的综合治疗原则。 lecturing contents 36 1、The introduction of intracranial tumors(etiology、classification、predilection site) 2、clinical features and diagnosis of neurogliocytoma 、meningioma 、pituitary tumor、acoustic neuroma、craniopharyngioma 、angioreticuloma. 3、the composite therapies of intracranial tumors. 37