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shuang ce yan sui nei ce geng si 1 li ji wen xian fu xi
Pages: 121-122
Year: Issue:  12
Journal: Chinese Journal of Practical Nervous Diseases

Abstract: 1病例资料 患者 女,54岁,以"进行性四肢麻木无力、饮水呛咳3 d"为主诉于2016-08-15入我院神经内科.患者3 d前腹泻后出现全身酸痛,随之四肢麻木,远端为重,伴四肢无力,饮水呛咳、吞咽困难、颈部发硬、气短,至县医院住院治疗,查头颅CT未见明显异常,以"吉兰-巴雷综合征"为诊断,予以营养神经等对症治疗,患者自觉症状进行性加重,遂来我院.行磁共振示双侧延髓内侧急性梗死.既往高血压史8 a,冠心病史5 a,正规治疗.体格检查:T 36.2 ℃,P 82次/min,R 19次/min,Bp 154/96 mmHg,心肺腹无异常.神经系统检查:神志清楚,言语流利,双瞳孔等大等圆,直径约3.0 mm,对光反射灵敏,眼球运动自如,无震颤,余脑神经检查无异常,四肢肌力Ⅳ级,四肢肌张力正常,四肢腱反射(+++),病理征阳性,四肢深感觉减退,浅感觉正常,双侧指鼻试验正常,颈强直.
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