临床资料 4例患者均为男性,年龄自53岁至80岁,平均为67岁。2例患者既往无特殊病史,1例有高血压病史,1例有肺结核病史。神经系统的症状和体征:4例患者均有延髓麻痹的表现,其共同点是起病突然,以头晕、走路不稳为首发症状,伴有声音嘶哑、饮水呛咳及吞咽困难。其中1例有一过性意识丧失,1例有明显的恶心、呕吐,1例表现偏侧肢体麻木及无力。从查体来看,均表现 Clinical data 4 patients were male, aged from 53 to 80 years old, with an average of 67 years old. Two patients had no previous history of a particular medical history, one had a history of hypertension, and one had a history of tuberculosis. Symptoms and signs of the nervous system: 4 patients had bulbar paralysis, the common point is the sudden onset, dizziness, walking instability as the first symptom, accompanied by hoarseness, cough, drinking water and difficulty swallowing. One of them had a transient loss of consciousness, one had obvious nausea and vomiting, and one had unilateral limb numbness and weakness. From the physical examination, are performance