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患者,男,58岁。该患于1991年1月5日回家后,突觉左面部疼痛,逐渐加重,难以忍受,伴恶心但未吐,于病后5小时急诊入院。既往:健康,否认高血压及三叉神经痛病史。体温36℃。血压22/12kPa,内科系统无异常。神清语明,双瞳孔等大,左瞳孔光反射迟钝,视乳头界清,眼球各向运动良,左面部潮红,三叉神经2、3支分布区痛觉过敏,伸舌居中,脑膜刺激征(一),四肢肌力、肌张力及感觉系统均正常,无病理反射,直肠膀胱功能正常。初诊为三叉神经痛,对症治疗,次日晨左面部疼痛加剧并伴有左头部胀痛,语言重复,条理性差。查体:体温37.2℃,意识清,语言流利。定向力正常,命名性失语,无失读、失写及失结构状态。神经系统仍无其
Patient, male, 58 years old. The affected patient on January 5, 1991 came home, suddenly felt pain in the left side of the face, and gradually aggravated, unbearable, with nausea but not vomiting, emergency 5 hours after admission. Past: health, denial of hypertension and history of trigeminal neuralgia. Body temperature 36 ℃. Blood pressure 22 / 12kPa, no abnormal internal medicine system. Clear clear language, double pupil and other large, left pupil light reflex slow, clear the optic disc, the eye movement of good, left flushed, trigeminal nerve 2,3 distribution area hyperalgesia, tongue middle, meningeal irritation A), limb muscle strength, muscle tone and sensory system are normal, no pathological reflex, normal bladder function. Newly diagnosed as trigeminal neuralgia, symptomatic treatment, the next morning morning left facial pain and accompanied by left head pain, language duplication, poorly organized. Physical examination: body temperature 37.2 ℃, clear consciousness, fluent language. Normal orientation, nominal aphasia, no loss of life, loss of writing and loss of structural status. The nervous system still does not have it