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患者男,60岁。无神经系疾病家族史。因进行性对称性四肢远端感觉异常伴无力1年余而就诊。查体:双手及下肢精细触觉、痛觉及震颤觉减退,远端肢力减弱,无肌萎缩,反射消失。EMG示股四头肌、胫前肌及伸趾短肌慢性神经损害,双腓肠神经感觉传导速度缺失。脑脊液常规及生化检查正常。华氏反应及血清维生素B_(12)测定均正常。按病因不明的进行性周围性多神经病进行治疗,病情仍缓慢加重。于病程第7年出现肌肉萎缩、感觉障碍加重。1980年(即病程第8年)出现舌、双下肢显
Male patient, 60 years old. No family history of neurological diseases. Due to progressive symmetry limbs distal abnormalities with weakness more than 1 year treatment. Physical examination: hands and legs fine touch, pain and tremor feel diminished, distal limb weakness, muscle atrophy, reflex disappeared. EMG showed quadriceps, anterior tibial muscle and extensor aponeurosis chronic nerve damage, double sural nerve sensory conduction velocity is missing. Cerebrospinal fluid routine and biochemical tests were normal. Fahrenheit reaction and serum vitamin B_ (12) were normal. By unknown cause of peripheral polyneuropathy for treatment, the condition is still slow to aggravate. 7th year in the course of muscle atrophy, increased sensory dysfunction. In 1980 (ie, duration of the first 8 years) appear tongue, both lower extremities were significant