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患者,男32岁。于1991年4月16日入院。13个月前无明显诱因出现左侧肢体运动失灵伴有麻木感,呈进行性加重。3个月后出现复视及语笨。就诊两所医院,先后3次行头部CT检查(其中两次为增强CT),均未见有异常,对症治疗未见有好转,症状逐渐加重。既往健康,查体:心肺检查未见异常。神志清晰。语言稍笨拙,双侧瞳孔等大同圆,对光反射灵敏,右眼外展不能,右侧鼻唇勾变浅,右侧额纹变平,右眼闭眼力弱,鼓腮不能。右舌肌薄,凹凸不平,伸舌右偏。肌力左上肢为重级,左下肢Ⅳ级,肌张力正常。痛觉正常,左肢腱反射稍活跃。左Babinski征(+)。经脑干MRI检查:脑干神经胶质瘤。因病变部位及范围不能手术治疗。经内科对症治疗无效出院。7个月后因恶病质死亡。
Patient, male, 32 years old. On April 16, 1991 admission. 13 months ago there was no obvious incentive for left limb movement failure associated with numbness, was progressive increase. 3 months after diplopia and language stupid. Visits to the two hospitals, head CT examination 3 times (including two enhanced CT), no abnormalities were seen, no improvement in symptomatic treatment, symptoms gradually aggravated. Past health, physical examination: no abnormal heart and lung examination. Consciousness. Language slightly clumsy, bilateral pupils and other Datong, sensitive to light reflex, right eye can not be abducted, the right nasolabial folds shallow, right forehead flattening, right eye closed eyesight weak, drum gills can not. Right tongue thin, uneven, stretch tongue right side. Muscle left upper limbs for heavy, left lower limb Ⅳ grade, muscle tone normal. Pain normal, left tendon reflex slightly active. Left Babinski sign (+). The brain stem MRI examination: brain stem glioma. Because of the lesion site and the scope of surgery can not be treated. The medical treatment of symptomatic invalid discharge. Died of cachexia after 7 months.