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于某,男性,68岁,因右半身活动不灵活4天,左眼脸下垂3天,于90年6月8日以脑干病变住院。患者入院前5天晨起床时发觉右下肢活动不灵活,右手不自主运动,系衣扣笨拙,次日开始左上脸下垂,不能睁眼。起病后神清,无头痛,呕吐,无抽搐,尿便失禁。既往健康。入院查体:BP22.0/14.2kPa,神清语明,左上睑完全下垂,左眼外展位,内收,上下视均不能,右眼球活动充分,瞳孔等大,光反射存在,眼底动脉细,反光增强。双侧鼻唇沟等深,伸舌居中,悬雍垂不偏,双软腭抬举对称,咽反射存在,右上肢不自主运动,右侧肢体肌力Ⅳ级,肌张力轻度增高,双侧腱反射存在,病理反射未引出。右手指鼻试验不稳住,轮替试
In a certain, male, aged 68, was inflexible for 4 days on the right half of the body and drooped on his left eye for 3 days. He was hospitalized with a brain stem disease on June 8, Patients found that the right lower extremity activities are not flexible, get rid of his right hand involuntary movements, Department of buckle clumsy, the next day began to sag left upper left, can not open your eyes. After the onset of God clear, no headache, vomiting, no convulsions, urinary incontinence. Past health. Admission examination: BP22.0 / 14.2kPa, clear and clear statement, the left upper eyelid completely drooping, left eye abduction position, adduction, upper and lower as can not, full right eyeballs, pupils and other large, light reflex exists, fundus artery fine , Reflective enhanced. Bilateral nasolabial fold and other deep, tongue middle, uvula is not biased, symmetrical lifting of the palate, pharyngeal reflex, right upper limb involuntary movement, right limb muscle strength grade Ⅳ, mild muscle tone increased, bilateral tendon reflex Existence, pathological reflex did not lead. Right finger nasal test instability, the rotation test