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椎动脉病变可引起下运动神经元功能障碍,但其病因还不清楚,报道一例因右侧椎动脉夹层分离而引起的双上肢远端肌萎缩。男,39岁,在醉酒后的晚上,突然出现眩晕并伴有呕吐,2h后因左臂剧烈烧灼样痛而疼醒,疼痛自左臂扩展至胸部和右臂,持续5min,3h后醒来发现其上肢不能活动,但能行走,几个h内肩部力量逐渐改善,但手仍然无力。查体;血压,20.5/14.5kPa(154/109mmHg)。颅神经正常,手握抓无力,手指不能伸展,双侧肱三头肌张力消失,旋前园肌和肱三头肌反射消失,步态不稳,
Vertebral artery lesions can cause dysfunction of motor neurons, but the etiology is unclear, reported a case of right upper extremity distal muscle atrophy caused by the separation of the right vertebral artery dissection. Male, age 39, drowsiness and vomiting at night after drunkenness. After 2 hours, the patient suffered from severe pain and painful awakening of his left arm. The pain extended from the left arm to the chest and right arm for 5 minutes and then woke up after 3 hours Found that the upper limbs can not move, but can walk, shoulder strength within a few h gradually improved, but the hand is still weak. Physical examination; blood pressure, 20.5 / 14.5kPa (154 / 109mmHg). Normal cranial nerves, hand grasping weakness, fingers can not stretch, bilateral triceps tension disappears, pronation Park triceps muscle and muscle reflex disappeared, unsteady gait,