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突然四肢瘫及高颅压为主要表现的多发性硬化(下称MS)不多见,现将我院1例报告如下: 张××,女,17岁,农民,因突然四肢瘫痪及头痛2天于89年11月7日入院。患者于11月5日晚上9时上厕所,突然四肢活动不灵,双手握拳,头胀痛,无抽搐、发热、尿便及意识障碍,当地医院诊断“癔病”。5个月前因失明,在某医院诊断球后视神经炎。经治疗视力有所恢复,但用药不详。血压16/10.6kPa,心肺正常,肝脾未触及。神经系统检查:嗜睡,表情淡漠,反应迟钝、语明,两眼球各向运动受限,瞳孔正常,对光反应存在。无眼球震颤,双侧视神经萎缩,视力1.5米指数。项强2横指,四肢肌力2级,肌张力增高,腱反射亢进,双侧病理反射(+),无感觉障碍。实验室检查:血尿便常规正常,心电图正常,脑电图轻度异常。肝功正常,血电解质正常。11月8日作头颅CT:见双侧大脑半球白质大面积水肿改变,双侧脑室对称性狭窄,中线结构无移位,增强后见大脑半
Suddenly limbs paralysis and high intracranial pressure as the main manifestation of multiple sclerosis (hereinafter referred to as MS) rare, now a hospital in our report as follows: Zhang × ×, female, 17 years old, farmers, due to sudden quadriplegia and headache 2 Days in November 7, 89 admission. The patient went to the toilet at 9 o’clock on the night of November 5. Suddenly his limbs were not working properly. His hands were fist-punching, his head was swollen and pain was gone. He had no convulsions, fever, urine stools and unconsciousness. The local hospital diagnosed “hysteria.” 5 months ago because of blindness, diagnosis of posterior optic neuritis in a hospital. After treatment, visual acuity has been restored, but the medication is unknown. Blood pressure 16 / 10.6kPa, normal heart and lung, liver and spleen not touched. Nervous system examination: lethargy, indifferent expression, unresponsive, language, the two eye movement is restricted to all, the pupil normal, the presence of light response. No nystagmus, bilateral optic atrophy, visual acuity of 1.5 meters. Xiangqiang 2 horizontal means, limb muscle strength 2, increased muscle tone, tendon hyperreflexia, bilateral pathological reflex (+), no sensory disturbances. Laboratory tests: routine urine hematuria, normal ECG, mild abnormal EEG. Normal liver function, blood electrolyte normal. November 8 for head CT: see large bilateral bilateral cerebral hemisphere white matter edema, bilateral symmetrical stenosis, no shift of the midline structure, enhanced after the brain half