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患者女,47岁。因四肢末梢麻木伴活动障碍4年而于1990年7月14日入院。双足先麻木后渐向近心端发展,半年后行走障碍伴双手麻木,指活动受限,左眼有时视物模糊。经针灸,理疗,口服维生素、激素等治疗病情时轻时重,近半年病情加重不能独立行走,余无不适。查体:T37℃,P76次/分,R18次/分,BP13.3/8.00kPa,发育正常,双侧眼底视神经乳头轻度水肿,双手大鱼际肌、骨间肌腓肠肌对称性萎缩。右手第二至五指略呈屈曲状不能伸直及并拢,跟膝腱反射迟钝,四肢远端感觉减退,呈手套袜套样分布,病理征未引出。心电图正常。头颅CT正常。实验室检查:CSF:WBC0-3个/mm~3,蛋白:4.6g/L。血IgA:2640mg/L IgM:1600mg/L C_3:740μg/ml CD_4:38～42％CD_8;18～
Patient female, 47 years old. Due to peripheral limb numbness with mobility disorder for 4 years and was July 14, 1990 admission. After the numbness of the feet first gradually toward the proximal end of development, six months after walking obstacles with numbness, refers to the activity is limited, the left eye and sometimes blurred vision. After acupuncture, physiotherapy, oral vitamins, hormones and other conditions when light weight, aggravating the past six months can not walk independently, I have no discomfort. Examination: T37 ℃, P76 beats / min, R18 beats / min, BP13.3 / 8.00kPa, normal development, bilateral edema of the optic nerve head of the fundus, both hands big attic muscle, interspinous gastrocnemius symmetry atrophy. The second to the fifth finger slightly curved shape can not be straight and close together, with knee tendon reflex dull, remote sense of limbs decreased, was glove-like sock-like distribution, the pathological levy did not lead. Normal ECG. Head CT is normal. Laboratory tests: CSF: WBC0-3 / mm ~ 3, protein: 4.6g / L. Blood IgA: 2640mg / L IgM: 1600mg / L C_3: 740μg / ml CD_4: 38 ~ 42% CD_8; 18 ~