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患者,男、46岁,因四肢僵直逐渐加重1月余于90年2月15日入院。90年1月开姑左上肢发僵,活动不灵,半月后左腿阵发性酸痛、僵直,2月6日右上肢亦出现同样症状,此后逐渐加重,每于受凉或生气后出现四肢发作性僵硬,每次持续2分钟,入院前5天觉胸闷气短,说话声小,进食费力。既往体健,家族史(一),体检:心肺腹无异常,神清、卧床不能动,轻度角弓反张、面部表情少,说话声小,颅神经无异常。右上肢无自主活动。余肢体Ⅲ～Ⅶ级肌力,肢体刺激后呈僵直状,腱反射活跃,腹肌紧张触之如板状,入睡后减轻,叩击前臂肌肉有肌球出现,血尿常规及肝肾功能等未见异常。肌电图检查右肱二头肌,双股四头肌、腹直肌安静时可见大量持
The patient, male, 46, was admitted to hospital on February 15, 1990 due to stiffening of his limbs. In January 1990, her left upper limbs were stiff and ill-functioning. After half a month, her left leg had paroxysmal soreness and stiffness. The same symptoms appeared on the upper right leg on February 6 and then gradually increased. Her limbs were exacerbated after her cold or angry Sexual stiffness, each lasting 2 minutes, 5 days before admission feel chest tightness, shortness of breath, small voice, eating hard. Past physical health, family history (A), physical examination: no abnormal heart and lung abdomen, Shen Qing, bed rest can not move, slightly angle bow anti-Zhang, facial expression less, voice is small, no abnormal cranial nerves. Right upper limb without activity. I limbs Ⅲ ~ Ⅶ level of muscle strength, limb stiffness after stiff stimulation, active tendon reflexes, abdominal muscle tension such as the plate touch, reduce after sleeping, percussion forearm muscle myosotomy, hematuria, liver and kidney function, etc. See abnormalities. EMG examination of the right biceps, double quadriceps, rectus abdominis visible when a large number of quiet