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1 资料患者,男,13岁,1年前家长无意中发现患儿讲话时口齿不清伴流涎,如将“吃饭”说成“吃换”,同时伴有视物模糊、头晕,病情呈渐进性加重,病后3个月出现明显萎靡、乏力、食欲减退、多睡以及注意力、记忆力减退等症状,起病后7个月,突发抽搐,呈强直-阵挛状发作。服苯妥英钠0.2/d及中药,抽搐未完全控制, 步态更加不稳,于病后1年收入院。既往史、个人及家族史均无特殊。体格检查:内科系统检查未见异常。神经系统检查:神清, 理解、判断力尚可,计算力差。语言含混,吐字不清。步态蹒跚呈醉酒状,眼底视乳头边界清,视力左0.1,右0.25,眼球各方活动好,粗大水平旋转眼震,鼻唇沟对称,伸舌居中,软腭上提正常,双侧咽反射弱。四肢活动好,肌力正常,张力低。四肢腱反射(++ +),双踝阵挛阳性,腹壁、提睾反射减弱。浅深感觉正常。双侧
1 data patients, male, 13 years old, a year ago, parents inadvertently found in children speech slurred mouth with salivation, such as the “meal” as “eat and change”, accompanied by blurred vision, dizziness, the condition was gradual Sexual aggravate, 3 months after the onset of significant malaise, fatigue, loss of appetite, more sleep and attention, memory loss and other symptoms, 7 months after onset, sudden convulsions, was ankylosis - clonic seizures. Services phenytoin 0.2 / d and Chinese medicine, convulsions are not fully controlled, more unstable gait, 1 year after the illness income hospital. Past history, personal and family history are no special. Physical examination: Internal medical examination showed no abnormalities. Nervous system examination: God clear, understanding, judgment is acceptable, poor calculation. Mixed language, articulation unclear. Gait hobbled drunk like the nipple clear border, visual acuity left 0.1, right 0.25, all activities of the eyeballs are good, coarse horizontal rotation nystagmus, symmetrical nasolabial fold, extensor middle, soft palate raised normal, bilateral pharyngeal reflex weak. Good limb activity, normal muscle strength, low tension. Limb tendon reflex (++ +), double ankle clonus positive, abdominal wall, cremasteric reflex decreased. Shallow feeling normal. Bilateral