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患者 女,5岁,出生时外貌正常,生后1岁内经常感冒,家人发现其生病注射药物时,从不喊痛。发育较同龄儿差,18个月会走路,常有跌伤、无疼痛反应。情绪不稳定,易激怒,多动。出牙后常咬硬物(鞋底、石头等),而使牙齿残缺不全。自残,双手反复咬伤合并感染。4岁时无诱因出现发作性意识丧失,四肢抽搐,双眼上视,尿失禁,持续1分钟左右缓解,经脑电图检查诊断为“癫痫”,给予硝基安定5mg,每日2次口服,病情控制,半年发作2次。近2个月来频繁出现失神发作,每天发作3～4次,停用硝基安定。鲁米纳30mg、每日3次口服,2周后发作减少。查体:五官端正,发育营养尚可,身高体重与同龄人基本相符。牙齿残缺不全,牙龈变黑,下唇及双手多处咬伤瘢痕,双手桡侧咬伤处已部分破溃。言语迟纳,欣快,智力低下。颅神经检查阴性,脑膜刺激征阴性,双侧深浅反射对称适中,未引出病理反射。四肢肌力、肌张
Female patient, 5 years old, normal appearance at birth, 1 year after birth often cold, family members found their illness injection of drugs, never shout. Poor development than the same age, 18 months will walk, often fall injury, no pain reaction. Emotional instability, irritability, hyperactivity. Teeth often bite hard objects (soles, stones, etc.), leaving incomplete teeth. Self-mutilation, repeated bites his hands with infection. 4-year-old no incentive to episodic loss of consciousness, limbs convulsions, binocular vision, urinary incontinence, sustained about 1 minute relief, diagnosed as “epilepsy” by EEG, given nitrazepam 5mg, 2 times daily oral, Disease control, two seizures 2 times. Nearly two months to frequent loss of appetite, attack 3 to 4 times per day, stop using nitrazepam. Lumina 30mg, 3 times a day orally, seizures decreased after 2 weeks. Physical examination: facial features, developmental nutrition is acceptable, height and weight are basically consistent with their peers. Tooth incomplete, dark gums, lower lip and hands bite many scars, both hands radial ulcer has been partial ulceration. Speech late satisfied, euphoric, mental retardation. Negative cranial nerves examination, negative meningeal irritation, both sides of the symmetry of deep and shallow reflection, did not lead to pathological reflex. Limb muscle strength, muscle tension