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患者男性,36岁,已婚,初中文化,农民。1983年11月份因言语性幻听、生活懒散等被诊断为精神分裂症。住院治疗两次,疗效均差。第一次服用奋乃静等,后因夜眠差而于第二年换服氯氮平至今,最大量为300mg/d,最小量的175mg/d。近15年服氯氮平除言语性幻听消失外其余无改善,且社会功能减退。起病初两次脑电图无异常,既往无癫痫发作史。2000年3月16日19时30分患者顿服氯氮平175mg后不足30分钟出现腹痛,遂后双下肢发软,而跪于地上乱摸,家人呼之能答。十余分钟后患者突然倒地,牙关紧闭,四肢发直,全身抽搐,未见口吐白沫。五分钟后停止,呼之不答,每间断四十余分钟后又抽搐五分钟。四小时后送本院就治,入院查体:神态昏迷,锥体束征阴性,T37.7℃,R22次/分,P95次/分,BP100/80mmHg,牙关紧闭,嘴角向外溢血,后证实
Male patient, 36 years old, married, junior high school, farmer. In 1983 November due to verbal auditory hallucinations, life was diagnosed as schizophrenia. Hospitalized twice, the effect is poor. For the first time taking perphenazine, etc., because of night sleep difference in the second year for clozapine so far, the maximum amount of 300mg / d, the minimum amount of 175mg / d. Nearly 15 years of service clozapine in addition to verbal hallucinations disappeared without the rest of the rest, and social dysfunction. The beginning of the second EEG no abnormalities, no previous history of seizures. At 16:30 on March 16, 2000, the patient appeared to have abdominal pain after less than 30 minutes of taking clozapine 175mg. His lower extremity became soft and his knees fell on the ground. More than ten minutes after the patient suddenly fell to the ground, teeth closed, limbs straight, generalized convulsions, no spit foam. Stop after five minutes, do not answer the call, each episode more than forty minutes and then convulsions five minutes. Four hours after the hospital sent to the treatment, admission examination: staring unconscious, pyramidal tract signs negative, T37.7 ℃, R22 times / min, P95 beats / min, BP100 / 80mmHg, teeth closed, mouth outward bleeding, After confirmed