患者,男性,19岁,因言语不清、右手活动不灵3 d入院。发病前3 d晨起后无明显诱因出现舌根发硬、言语欠流畅,次日自觉右手活动不灵,写字时手指笨拙,偶有饮水呛咳,无其他伴随症状。其母诉患者小时智力佳,初中后逐渐出现易疲劳、记忆力减退、成绩下降,被迫高中肄业。无相关家族史。查 Patient, male, 19 years old, admitted to hospital due to unclear speech and ill-functioning right hand. 3d before the onset of the morning after onset there is no obvious incentive to tongue hard, the language owed smooth, the next day conscious right hand movement is not working, when writing fingers clumsy, occasional drinking choking cough, no other accompanying symptoms. The mother sued the patient hours of good intelligence, fatigue gradually after junior high school, memory loss, decline in performance, was forced to high school employment. No related family history. check