1　临床资料　　患者男 ,49岁 ,患癫痫 2 0年 ,伴恶心、呕吐 1天入院。2 0年来 ,长期服用丙戊酸钠、卡马西平等。查体 :T36 .7℃ ,BP18/ 10 k Pa。神志清 ,精神软 ,浅表淋巴结未及 ,巩膜不黄 ,心肺 (- ) ,腹软 ,无压痛 ,肝脾未及 ,肠鸣音不亢 ,双下肢无浮肿 ,四肢抽搐 ,肌张力 1 Clinical data Patient male, 49 years old, suffering from epilepsy 20 years, with nausea, vomiting 1 day admission. 20 years, long-term use of sodium valproate, carbamazepine equality. Physical examination: T36 .7 ℃, BP18 / 10 kPa. Consciousness, the spirit of soft, superficial lymph nodes, sclera is not yellow, cardiopulmonary (-), abdominal soft, no tenderness, liver and spleen and bowel sounds not hyperactivity, both lower extremities without edema, limbs twitching, muscle tension