女患,40岁,1982年发现有时双睑睁开很困难,伴视物双影,闭目休息后好转,说活鼻音重。约5个月后出现言语含糊不清,饮水呛,吞咽困难,嘴嚼无力。上述症状下午重于清晨,体力劳动后出现双上肢发软、无力,休息后好转。无四肢疼痛、麻木,无呼吸困难。家族遗传史:其父母为近亲结婚(姑表亲)。患者父亲37岁时出现睁眼无力,伴视物双影,说话鼻音重,言语含糊不清,嘴嚼吞咽均缓慢,未予治疗,52岁时卧床不起,呼吸困难,不能进食而病故。大 Female, 40 years old, found in 1982 and sometimes double eyelid is very difficult to open, with visual double shadow, closed eyes improved after the break, said living nasal weight. About 5 months after the words appear vague, drinking choke, swallowing difficulties, mouth chewing weakness. The above symptoms are heavier in the early afternoon, after physical exertion, both upper extremities are weak and weak, rest after improvement. No limb pain, numbness, no breathing difficulties. Family history: His parents are married relatives (cousins). When his father was 37 years old, his eyes were weak with his eyes open, his eyes covered with double images, his nasal sounds were heavy, his speech was ambiguous, his mouth chewing swallowed slowly, and he was untreated. He was bedridden at 52 and had difficulty breathing and could not eat and died. Big