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患者,男,19岁,因精神异常伴发作性四肢抽搐6天,拟诊散发性脑炎入院.患者曾患“皮肤病”2年,初起为鳞屑性红斑,以后为色素沉着。入院前6天与其母争吵后,夜间失眠,头部胀痛,恐怖感,胡言乱语,坐立不安.此症状持续2天,后体温升高达38℃,伴发作性神志不清,四肢抽搐.口角歪斜,大小便失禁,间歇期神志清晰。病前个性强,好生闷气。家族无类似病史.入院检查,一般情况好,皮肤颜面对称性暗红色斑片,部分呈毛囊性丘疹,表面附以鳞屑,双手前臂伸侧有广泛咖啡色斑片,表面附以粗糙的鳞屑;颈前、前脚、背上呈淡红色斑片,部分表面有少许脱屑。神经系统检查:无阳性发现。精神检查:思维异常,有幻视、幻听及被害感。两次脑脊液检查均正常。脑电图示
The patient, male, 19 years old, was admitted to hospital with an episode of sporadic encephalitis due to mental abnormalities for 4 days with convulsions of the extremities. The patient had had a “skin disorder” for 2 years and was initially squamous erythema and later pigmented. 6 days before admission to his mother quarrel, night insomnia, head pain, horror, nonsense, restlessness .This symptom lasted 2 days, after the body temperature rose up to 38 ℃, with episodic delirium, limbs convulsions. Askew, incontinence, intermittent conscious. Pre-sick personality, so raw sulking. Family no similar history. Admission examination, the general situation is good, facial symmetry dark red patches, some were follicular papules, the surface attached to the scales, both hands forearm extension of a wide range of brown patches, the surface attached to the rough scales; Neck, forefoot, pale red patches on the back, some surface a little scaling. Neurological examination: no positive findings. Mental examination: abnormal thinking, visual hallucinations, auditory hallucinations and victimization. Both cerebrospinal fluid tests were normal. EEG icon