患者,男,21岁,住院号5196。患者于1991年10月11日始至1992年1月10日从事碘甲烷生产。由于设备不严,生产时温度需控制在50～60℃之间,故厂房内每天有大量碘甲烷蒸气逸出。厂房面积50m~2,高8m,而且在过滤时需抽100ml碘甲烷进行分离,温度控制在42～43O℃,无封闭,此项操作每日持续40～60分钟。同工种12人,4人发病。工人无防护措施。患者自接触碘甲烷第二周始出现头晕、嗜睡症状,未予注意。直至入院前一周,工作时突然头晕、摔倒,当时无意识丧失,被人扶起。此后头晕、嗜睡加重,伴有多梦、谵妄、幻觉、躁狂、心悸、胸闷、气短、食欲不振、恶心、呕吐、四肢乏力、麻木以至瘫痪、视物不清、复视。体检:T、P、R、BP均正常,表情淡漠,言语困难,不能行走。全身皮肤粘膜未见皮疹,结膜无充血,巩膜无黄染,颈软,心肺未闻及异常,腹部平坦、软,肝 Patient, male, 21 years old, hospital number 5196. Patients were engaged in methyl iodide production from October 11, 1991 until January 10, 1992. Due to the equipment is not strict, the production temperature to be controlled between 50 ~ 60 ℃, so the plant daily large amounts of methyl iodide vapor escape. Plant area of ​​50m ~ 2, 8m high, but also in the filtration need to take 100ml of methyl iodide separation, temperature control at 42 ~ 43O ℃, no closure, the daily operation of 40 to 60 minutes. The same type of work 12 people, 4 onset. Workers without protection measures. Patients with dizziness, narcolepsy symptoms from the second week of exposure to methyl iodide, did not pay attention. A week before admission, she suddenly became dizzy and fell while at work. At that time her unconscious was lost and was lifted up. After dizziness, drowsiness increased, accompanied by dreams, delirium, hallucinations, mania, palpitations, chest tightness, shortness of breath, loss of appetite, nausea, vomiting, weakness, numbness and even paralysis, blurred vision, diplopia. Physical examination: T, P, R, BP are normal, apathetic expression, speech difficulties, can not walk. No skin rash of the skin and mucous membranes, conjunctival hyperemia, scleral no yellow dye, neck soft, heart and lungs are not heard and abnormal, flat belly, soft, liver