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患儿 女,1岁。1988年2月16日因发热、呼吸不规则和昏睡5天转入我院。患儿自1987年10月始渐出现双下肢软弱无力且进行性加重,无呕吐和抽搐。1988年2月始双上肢也渐无力,手不能握物,头能轻微转动,入院前已不能翻身。查体:浅昏迷,营养较差。T36.6℃,P120次/分,R40次/分。仰卧位,双侧肘及髋关节屈曲外展,膝关节屈曲。胸部平坦,胸式呼吸基本消失,腹式呼吸明显。颅神经(一)。四肢肌肉、胸大肌、骶棘肌、臀大肌等萎缩,肌张力明显减低。双上肢肌力0～I°,双下肢肌力0°。四肢腱反射消失,病理反射未引出。脑膜刺激征(一)。两
Children, 1 year old. February 16, 1988 because of fever, irregular breathing and lethargy 5 days into our hospital. Children from October 1987 began to appear both lower limb weakness and progressive increase, no vomiting and convulsions. Beginning in February 1988 both upper limbs gradually weakness, hand can not hold the object, the head can be slightly rotated, can not stand up before admission. Physical examination: shallow coma, poor nutrition. T36.6 ℃, P120 times / min, R40 times / min. Supine, bilateral elbow and hip flexion abduction, knee flexion. Flat chest, chest breathing basically disappeared, abdominal breathing was obvious. Cranial nerve (a). Limb muscles, pectoralis major, sacral spine muscle, gluteus maximus and other atrophy, muscle tension was significantly reduced. Double upper limb muscle strength 0 ~ I °, lower limb muscle strength 0 °. Limb tendon reflex disappeared, pathological reflex did not lead. Meningeal irritation (a). Two