The clinical manifestations of central infection with enterovirus 71 are variable and the severity of the disease varies. The main manifestations of EV71 central infection are aseptic meningitis, brainstem encephalitis, microcephalitis, polio-like syndrome, and encephalomyelitis, most of which occur in young children under 5 years of age, with the highest incidence in infants under 1 year of age. The main cause of death is cardiopulmonary failure secondary to brainstem encephalitis, with or without damage to the skin of the hands, feet, buttocks, and oral mucosa. The main manifestations of brainstem encephalitis are functional abnormalities of the dorsal brainstem and its adjacent neural tissues such as the vertebral tracts and cerebellum, which can present with abnormal eye movements such as nystagmus, pupillary abnormalities, myoclonus (mainly proximal limbs), gait instability and tremor, ataxia, cranial nerve abnormalities (especially the 6th and 7th cranial nerve pairs), meningeal irritation, tachycardia, abnormal bowel movements, vomiting, Hypertension, dysphagia, and altered consciousness. Among them, vomiting, tachycardia, hypertension and dysphagia are important signs of brainstem abnormalities. Brainstem encephalitis is classified into three classes according to the degree of neurological involvement: Class I shows myocardial tremor and ataxia, leaving permanent neurological sequelae in 5% of children; Class II shows myocardial tremor and cranial nerve involvement, leading to sequelae in 20% of children; Class III shows rapid cardiopulmonary failure, leading to death in 80% of children and serious sequelae in all survivors. This classification criterion is useful for guiding clinical diagnosis. Young age (17×109/L) is a major factor in the poor prognosis of EV71 infection involving the CNS. Potential risk factors for CNS involvement include hyperthermia,with a temperature greater than 39°C lasting more than 3 days, headache, vomiting, lethargy, convulsions, and hyperglycemia, with hyperthermia lasting more than 3 days being the most important.