1　病历摘要患者男 ,2 2岁 ,病程 2年。首发症状为声音嘶哑 ,饮水呛咳 ,且渐进性加重。初次就诊内科体检无异常 ,神经系统检查咽反射稍减弱 ,舌肌无明显萎缩 ,无舌肌纤颤 ,颅神经检查未见异常 ,四肢肌力 ,肌张力无异常 ,浅、深反射对称 ,无病理征。由于疲劳试验及药物试验可疑 1 patient summary Male patient, 2 2 years old, duration of 2 years. The first symptom is hoarseness, choking water, and gradual increase. No abnormalities were found in the medical examination of the first visit, the pharyngeal reflex of the nervous system was slightly weakened, there was no obvious atrophy of the lingual muscle, no tongue fibrillation, no abnormal cranial nerve examination, no abnormality of muscle strength and muscle tone of the limbs, shallow and deep reflex symmetry, no Pathological sign. Due to fatigue test and drug test suspicious