药物可以治疗疾病,使用不当也可以造成疾病。药源性疾患中,神经系统障碍占一定地位。本文以Hollister的《药物引起的神经系统障碍》一文为基础,结合近年的资料加以综述。为描述的方便,将按通用的方法分类讨论。至于精神障碍,不拟详述,可参阅《药源性精神障碍》一文。脑病症状群常指脑和脊髓的病变,包括出血性和脱髓鞘性损害。前者是药物的直接毒性,后者则常涉及过敏机制。临床表现为:头痛,意识障碍,癫痫发作和各种局灶性神经系体征。虽罕见,但死亡率较高。疫苗和抗血清可引起脑脊髓炎。接种后脑脊髓炎(PVE)多数发生于疫苗初次接种后的9～13天。动物免疫血清(如白喉抗血清、破伤风抗血清等)致神经系统反应较少;如有则在接种一周后出现脑脊髓病变和多发性神经炎。百日咳疫苗或含它的三、四联疫苗最易引 Medications can cure the disease, and improper use can also cause the disease. Drug-induced disorders, nervous system disorders account for a certain status. This article is based on Hollister’s article entitled “Drug-Induced Neurological Disorders”, combined with recent data. For the convenience of description, it will be classified according to a common method. As for mental disorders, which are not intended to be detailed, please refer to the article Drug-induced mental disorders. Encephalopathy Symptoms often refer to lesions of the brain and spinal cord, including hemorrhagic and demyelinating lesions. The former is the direct toxicity of drugs, which are often involved in allergic mechanisms. Clinical manifestations are: headache, disturbance of consciousness, seizures and a variety of focal neurological signs. Although rare, the mortality rate is higher. Vaccines and antisera can cause encephalomyelitis. Post-vaccination encephalomyelitis (PVE) mostly occurs 9 to 13 days after the initial vaccination. Animal immune serum (such as diphtheria antiserum, tetanus antiserum, etc.) caused less nervous system reaction; if there is a week after vaccination, there is a brain myelopathy and polyneuritis. Pertussis vaccine or vaccine containing it, the most likely to lead three or four