The incidence of neuroleukopenia (NBD) has been reported abroad to be 5-30%, with a male to female ratio of 4:1, mostly occurring months to years after the onset of symptoms of leukopenia (BD) (average 3-6 years), with 99% of central nerve involvement, which can be divided into meningoencephalitis, brainstem, spinal cord, peripheral neuropathy, cerebellar lesion, cranial nerve palsy, etc. according to the site of involvement, with the brainstem type being the most common. Hemispheric involvement is less common. Patients with this type of NBD have the most severe disease and the worst prognosis, with 20-30% having continuous progression. Currently, the first-line drugs for the treatment of NBD at home and abroad are azathioprine and methotrexate combined with glucocorticoid therapy, and cyclosporine can be used for high-risk patients. Antagonist of tumor necrosis factor-alpha (anti Tumor Necrosis Factor-a, aTNF-α) for NBD has been reported in 40 cases. Most of the cases were treated with aTNF-α in combination with glucocorticoids, and some were treated with immunosuppressive agents such as azathioprine on top of that. In total, 36 cases of infliximab, 1 case of etanercept, and 3 cases of adalimumab were reported. From the statistics of small data, infliximab was the most studied, with the longest follow-up time of 6 years. A 4-year follow-up meeting of infliximab alone without combined hormone therapy for NBD had been reported, and 30 of the 36 cases were clearly reported with significant efficacy (83.3%), 3 with improvement (8.3%), 2 with slow progression (5.6%), and 1 with ineffectiveness (3.3%). Etanercept was the least reported and there were reports that etanercept was less effective than infliximab and adalimumab. only 3 cases of adalimumab for NBD were reported, 1 of which was reported as a case of relapse 1 year after discontinuation of infliximab treatment and effective treatment with adalimumab, involving the right hemisphere and spinal cord involvement. 1 case was reported as a brainstem type case in which infliximab was ineffective and effective with adalimumab instead. The last case was reported in a 12-year-old patient with cerebellar type NBD, and no side effects were found in the minor. For the treatment of BD, there are a number of studies supporting that adalimumab is still effective in BD patients who have failed to respond to infliximab and relapsed after discontinuation, and that the switch to adalimumab was motivated by the fact that the failure to respond to infliximab may be due to the development of autoantibodies against infliximab. belzunegui et al. reported 69 cases of treatment with adalimumab after failure of infliximab for BD, with 9 of 17 cases in remission ( 52.9%) and 3 cases improved (17.6%). The mean median duration of treatment was 17.5 months.10 A study by Bawazeer et al. using adalimumab in patients with BD with ophthalmic manifestations found clinical remission with no side effects in all 11 patients, including one patient who was ineffective with conventional hormone combination immunosuppressive therapy as well as with infliximab but had an excellent response to adalimumab therapy. One case of BD-associated uveitis in which infliximab was ineffective and adalimum treatment was successful was also reported. In addition, methotrexate is also a first-line treatment, and the use of methotrexate in combination with dexamethasone intrathecal injection for NBD at our institution also helps to achieve rapid short-term remission in NBD with CNS involvement.