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患者,男性,60岁,农民。左眶额头痛伴簇状疱疹8天,右侧肢体失灵,意识障碍2天于88年8月2日入院。患者7月26日无诱因出现发烧头痛,随后左额部出现数簇丘疹及视物模糊。到当地县医院诊治,给予消炎对症治疗。3日后昏迷,尿失禁遂转我院医治。查体,心肺(—),腹(—)。神志模糊,左侧瞳孔5mm,对光反应消失.球结膜水肿,有大量分泌物。右侧瞳孔3mm,对光反应灵敏。眼底左侧未窥入,右侧正常。左侧中枢性面瘫,伸舌居中,咽反射迟钝。右侧肢体痛觉减退,右侧肢体肌力O—I级,肌张力低,右侧Babinski氏征(+)。腰穿CSF无色透明,压力1.52kPa,细胞数205×10~6/L,蛋白0.9g/L,糖、氯化物正常。WBC、血糖及肝功正常,血BUN11.4mmol/L。脑电图见左额颞区有短程慢波。入院考虑三叉神经眼支带状疱疹脑炎给予治疗。氢化考的松300mg每日
Patient, male, 60 years old, farmer. Left orbital forehead pain with herpes zoster 8 days, right limb failure, disturbance of consciousness 2 days in August 2, 88 admitted. Patients on July 26 had no incentive to have a fever headache, followed by several leprosy on the left forehead and blurred vision. To the local county hospital treatment, given anti-inflammatory symptomatic treatment. 3 days after the coma, urinary incontinence then transferred to our hospital. Physical examination, cardiopulmonary (-), abdominal (-). Ambiguity, the left pupil 5mm, disappeared on the light. Bulbar conjunctival edema, a large number of secretions. Right pupil 3mm, sensitive to light. The left eye did not peep into the right side of the normal. Central left facial paralysis, middle tongue, pharyngeal reflex slow. Hypocholesterisis on the right limb, O-I muscle strength on the right limb, low muscle tension, Babinski’s sign on the right (+). Waist through CSF colorless and transparent, pressure 1.52kPa, the number of cells 205 × 10 ~ 6 / L, protein 0.9g / L, sugar, chloride normal. WBC, normal blood glucose and liver function, blood BUN11.4mmol / L. EEG see the left frontotemporal area with short-range slow waves. Admission to consider the trigeminal nerve eye herpes zoster encephalitis for treatment. Hydrocortisone 300mg daily