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临床资料女性患者,42岁,因“头晕、言语不清、吞咽困难10 d”于2004年5月12日入我院,病前5 d 有发热,体温最高达39℃,予抗生素治疗后于入院前3 d 体温恢复正常,当地头颅 CT 未见异常。既往健康,否认疫苗接种、进食异种蛋白及过敏史。入院时体温36.1℃,无皮疹,心肺无异常,瞳孔直径3 mm,对光反射正常,双眼水平性眼球震颤,言语难以分辨,饮水呛咳,双侧软腭上抬力弱,咽反射丧失,伸舌困难,无舌肌萎缩。四肢肌力Ⅳ级,腱反射偏低,双侧
Clinical data Female patient, aged 42, was admitted to our hospital on May 12, 2004 because of “dizziness, unclear speech and dysphagia 10 d ”. She had fever for 5 days before her illness and the body temperature reached 39 ° C. Antibiotic treatment After 3 days before admission, the body temperature returned to normal, with no abnormality in the local head CT. Past health, deny vaccination, eating foreign proteins and allergies. Admission temperature 36.1 ℃, no rash, no abnormal heart and lung, pupil diameter 3 mm, normal light reflex, binocular horizontal nystagmus, speech difficult to distinguish, drinking water cough, bilateral soft palate weakening, loss of pharyngeal reflex, extension Tongue difficulties, no tongue atrophy. Ⅳ limb muscle strength, tendon reflexes low, bilateral