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病例:男,39岁。于入院前6小时开始感双下肢无力,逐渐加重至不能行走,并延及两上肢无力,无呕吐及大小便障碍。发病前2周患过“感冒”。既往无类似疾病发作史。查体:T 36.5,P 80,R 20,Bp 16/9.5kPa.神志清,甲状腺不肿大,心肺听诊无异常,肝脾于肋下未触及,四肢肌张力减低,双上肢肌力Ⅲ级,双下肢肌力Ⅱ级。近端较远端重,腱反射减弱,病理反射未引出,无感觉障碍。血常规正常。家属拒腰穿作脑脊液检查。初
Case: Male, 39 years old. Six hours before admission, he began to feel the weakness of the lower extremities, gradually aggravating until he could not walk, and extending the weakness of the upper extremities, vomiting and urinary incontinence. 2 weeks before the onset of a “cold.” No previous history of similar diseases. Physical examination: T 36.5, P 80, R 20, Bp 16 / 9.5kPa. Consciousness, thyroid enlargement, cardiopulmonary auscultation no abnormalities, liver and spleen in the ribs did not touch, limb muscle tension decreased, the upper limb muscle strength Ⅲ , Lower limb muscle strength Ⅱ level. The proximal end of the distal weight, tendon reflexes, pathological reflex did not lead, no sensory disturbances. Normal blood. Family members refused to wear cerebrospinal fluid for examination. early