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患者,男,36岁。1983年10月2日晚被金环蛇咬伤左足外踝下3cm处,当时两牙痕处出血不止,觉足背麻胀,即束扎下肢,挤出血液并用溪水冲洗伤口,即送卫生院扩创放血和服蛇药片,随后又再转送县医院,观察2天无不适而出院。1月后,突然出现右眼睑下垂,42天后左眼睑亦下垂,朝轻暮重,同时伴讲话发音困难,咀嚼和吞咽费劲。12月22日到广州某医院住院,当时体查:双眼睑下垂,眼裂5～6mm,双眼球上视受限,其余方向运动尚好。疲劳试验阳性,新斯的明试验阳性,二、三头肌腱反射,膝反射,跟腱反射均亢进。实验室检查:抗核抗体、血IgG、A、M、CH_(50)、C_3,脑脊液常规,生化均正常。给予激
Patient, male, 36 years old. October 2, 1983 night was bites bites the left foot 3cm below the lateral malleolus, when the two teeth bleeding at the site more than felt dorsiflexion, that bundle the lower limbs, squeeze out the blood and wash the wound with streams, that is sent to the hospital Expansion of blood and service snake pills, and then again transferred to the county hospital, observed two days without discomfort and discharged. After 1 month, the right eyelid drooped suddenly. After 42 days, the left eyelid also drooped and became lighter and heavier. At the same time, it was difficult to pronounce with speech, and chewing and swallowing became laborious. December 22 to a hospital in Guangzhou, was physical examination: double eyelid ptosis, 5 ~ 6mm eye split, both eyes on the ball as limited, the rest of the movement is good. Fatigue test positive, neostigmine test positive, two, three tendon reflex, knee reflex, Achilles tendon reflexes are hyperthyroidism. Laboratory tests: anti-nuclear antibodies, blood IgG, A, M, CH_ (50), C_3, cerebrospinal fluid routine, biochemical are normal. Give excitement