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以局限性运动性癫痫为首发症状的糖尿病较少见,易误诊。现将我科收治的3例报道如下: 1 病例介绍 例1 患者女,62岁,患者2年前曾因脑血管意外致左侧偏瘫,本次因右侧肢体抽搐2次于1992年3月入院。体查:血压22/13kPa,意识模糊,左侧肢体肌张力偏高,上肢肌力Ⅳ级,下肢肌力Ⅲ级,右侧肢体肌张力减低,肌力Ⅲ级,双侧Babinsk′s(+)。给予降颅内压,降血压及口服苯妥英钠等处理后,意识障碍程度加重,右侧肢体抽搐频繁,次日腰穿检查,脑脊液压力不高,色清,潘氏试验(一),糖354mg/dl,急测血糖33.3mmol/L,尿糖++++,尿酮(一),即改用胰岛素治疗,血糖降至8.6mmol/L时,患者抽搐停止,意识逐渐好转,右侧肢体肌力,肌张力恢复正常。痊愈出院。
Limitations of exercise-induced epilepsy as the first symptom of diabetes less common, easily misdiagnosed. Now 3 cases reported in our department are reported as follows: 1 case introduction Example 1 female patient, 62 years old, two years ago due to cerebrovascular accident caused left hemiplegia, the right limb convulsions 2 times in March 1992 Admission. Physical examination: blood pressure 22 / 13kPa, confusion, high left limb muscle tone, upper limb muscle strength grade Ⅳ, lower limb muscle strength Ⅲ grade, right lower limb muscle tone decreased, muscle strength Ⅲ grade, bilateral Babinsk’s (+ ). Given reduced intracranial pressure, blood pressure and oral phenytoin and other treatment, aggravating the degree of disturbance of consciousness, the right limb twitch frequently, the next day lumbar puncture, cerebrospinal fluid pressure is not high, color clear, Pan test (a), sugar 354mg / dl, rapid detection of blood glucose 33.3mmol / L, urine sugar ++++, urine ketone (a), that switch to insulin therapy, blood glucose dropped to 8.6mmol / L, the patient stopped convulsions, consciousness gradually improved, right limb muscle Force, muscle tone returned to normal. Healed and discharged.