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例1,男性,63岁。发作性语言不清,右面及右上肢抽搐3天,每次抽搐约1分钟,每天10多次,发作时意识清楚。有高血压病史15年,既往无癫痫及糖尿病史。查体:血压24.0/13.3 kPa,右上肢肌力Ⅲ级及不全运动性失语,腱反射右侧高于左侧,无病理征。脑电图示阵发性高幅慢波,间有棘慢波综合。头颅CT扫描正常。经抗癫痫药物治疗无效。后查得尿糖(+),尿酮(-),血糖16.47mmol/L,血钠140mmol/L,腰穿脑脊液糖13.2 mmol/L,予以静脉滴注胰岛素后抽搐发作停止,测血糖6.70 mmol/L,尿糖阴性。出院后继续用降糖药控制血糖,随访3年癫痫未再发作。
Example 1, male, 63 years old. Episodic language unclear, the right and upper extremity convulsions for 3 days, each twitch about 1 minute, 10 times a day, the onset of awareness. Has a history of hypertension for 15 years, no previous history of epilepsy and diabetes. Examination: blood pressure 24.0 / 13.3 kPa, right upper extremity muscle strength grade Ⅲ and incomplete aphasia, tendon reflex right than the left, no pathological signs. EEG shows paroxysmal high amplitude slow wave, spike between the slow wave synthesis. Head CT scan is normal. Anti-epileptic drugs ineffective. Urine (+), urine ketone (-), blood glucose 16.47mmol / L, serum sodium 140mmol / L, lumbar punctate cerebrospinal fluid 13.2mmol / L, after intravenous drip of insulin to seizure onset to stop measuring blood glucose 6.70mmol / L, urine negative. After discharge from the hospital continue to control blood sugar with hypoglycemic agents, 3 years of follow-up of epilepsy no further attacks.