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患者,男,60岁,工人,因右上睑下垂20天~+,于1990年5月15日收住我科,入院前20天,患者不明原因地出现右上睑下垂,视物成双,三天后右眼完全不能睁开,卧位时略减轻,起床后很快加重至不能睁眼,无其他肌肉疲劳现象,无明显头痛呕吐。门诊检查发现右上睑下垂,右侧瞳孔大于左侧,光反射减弱。以“右侧动眼神经麻痹原因待查”收入院。23年前曾患十二指肠溃疡伴上消化道出血。17年前因左上肢僵硬无力伴震颤诊断为帕金森氏综合征。个人及家族史无特殊。入院时查体:T36.5℃,P82次/分,R20次/分,BP13/7kPa,右上睑下垂,右眼不能睁开,右瞳3mm>左瞳2mm,右瞳光反射减弱,双眼球各方运动正常,无复视。左上、下肢齿轮样肌张力增高,左上肢静止性震
The patient, male, 60 years of age, was admitted to our department on May 15, 1990 due to the right upper eyelid ptosis for 20 days ~ +. 20 days before admission, the patient developed unexplained right ptosis, Days after the right eye can not open, slightly relieved when lying, get up and quickly increased to not open your eyes, no other muscle fatigue, no obvious headache and vomiting. Out-patient examination found that the right upper eyelid ptosis, the right pupil than the left, light reflex decreased. To “right oculomotor nerve paralysis reason to be investigated” income homes. 23 years ago suffering from duodenal ulcer with upper gastrointestinal bleeding. 17 years ago due to left upper limb stiffness with tremor diagnosis of Parkinson’s syndrome. No personal and family history. Admission examination: T36.5 ℃, P82 beats / min, R20 beats / min, BP13 / 7kPa, right upper eyelid ptosis, right eye can not open, right pupil 3mm> left pupil 2mm, right pupil light reflex decreased, Normal movement, without diplopia. Upper left and lower extremity gear-like muscle tone increased left upper extremity static shock