患者,男性,18岁。双睑下垂3个月,四肢无力、构音障碍、饮水呛咳一月余,于1991年12月入院。晨轻晚重,劳累后加重,无复视。入院查体阳性所见:双睑下垂遮盖瞳孔1/3,双眼球向下,上及左侧运动自如,向右同向注视不能。双耳灌注冰水时恢复正常,瞳孔等大同圆4mm,对光反射灵敏,但辐辏及调视反射消失,软腭动度差,咽反射稍减弱,四肢肌力Ⅳ级。肌疲劳试验阳性。新斯 Patient, male, 18 years old. Eyelid ptosis 3 months, limb weakness, dysarthria, drinking cough more than a month, admitted in December 1991. Morning light and heavy, exacerbated after exertion, no diplopia. Visits positive findings: double eyelid ptosis covered pupil 1/3, his eyes down, left and right movements freely, can not be the same to the right gaze. Binaural infusion of ice water returned to normal, the pupil and other Datong circle 4mm, sensitive to light reflection, but convergence and reflex convergence reflex, soft palate move poor, pharyngeal reflex slightly weakened, muscle strength Ⅳ grade. Muscular fatigue test positive. Neos