Objective To analyze the clinical manifestations and imaging features of human brainstem encephalitis with Parkinson syndrome as the main manifestations. Methods Combined with related literature, the clinical, laboratory and imaging features of three patients with brainstem encephalitis, which were mainly manifested as Parkinson syndrome, were analyzed. Results The 3-hour video EEG showed normal in 2 cases and abnormal in one case with more delta wave in each leads. Cerebrospinal fluid examination revealed normal cell numbers in one case, increased cell numbers in 2 case and elevated cerebrospinal fluid proteins in all 3 cases. serum and CSF IgG anti-NMO antibodies as well as autoimmune encephalitis antibodies were negative in 3 cases. Brain MRI showed symmetrical abnormal signal in bilateral midbrain and pia mater enhancement increased in 3 cases. After hormone, and madopar treatment, Parkinson syndrome symptoms were significantly improved in two patients. Conclusion Brainstem encephalitis-induced symmetrical midbrain lesion can manifest as Parkinson syndrome. The laboratory tests reveal an involvement of immune system and hormone therapy may be effective.%目的 分析表现为帕金森综合征的脑干脑炎临床表现、影像学特点.方法 回顾2例以帕金森综合征为主要表现的脑干脑炎患者临床、实验室检查和影像学检查特点,结合相关文献复习进行讨论分析.结果 2例患者3 h视频脑电图正常.1例患者脑脊液细胞数正常,1例增多.2例脑脊液蛋白均升高.脑脊液病毒筛查、血清及脑脊液抗NMO抗体IgG均阴性,自身免疫性脑炎抗体均阴性. 2例患者颅脑MRI均表现为双侧中脑对称性异常信号伴软脑膜增多强化.2例患者经激素或丙种球蛋白治疗及美多芭等治疗后,帕金森综合征症状均明显好转.结论 脑干脑炎可致对称性中脑病变,表现为帕金森综合征,经激素或丙种球蛋白治疗联合抗帕金森药治疗有效.
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