明某,女,42岁。8个月以前出现四肢静止时震颤,情绪激动时加剧,睡眠中消失。近3个月来多语,易激惹,焦虑不眠,走行缓慢,肢体发硬,震颤加重,于1986年12月15日入院。既往无发热抽搐史,无甲状腺疾患及阳性家族史。患者系足月顺产,自幼智能低下。查体:身体矮小,甲状腺不大,无血管杂音。Chrostek氏征(一),Trousseau氏征(一)。面具脸,表情呆板,幼稚气质,智能低下。四肢肌力正常,肌张力是齿轮样增高,静止性震颤,行走开始时有前冲步态,上肢摆动少,共济运动正常,四肢病理征(一)。初诊:帕金森氏综合征。入院后查血、尿 Ming, female, 42 years old. Tremor appeared when limbs quiesced 8 months earlier, aggravated by agitation, and disappeared during sleep. Nearly three months to multilingual, irritability, anxiety, sleepless, slow walking, stiff body, increased tremor, admitted on December 15, 1986. Previous history of fever without convulsions, no thyroid disease and a positive family history. Full-term patients with obstetrical, intelligent since childhood. Physical examination: short body, thyroid is not large, no vascular noise. Chrostek’s sign (a), Trousseau’s sign (a). Mask face, dull expression, childish temperament, low intelligence. Limb muscle strength is normal, muscle tension is gear-like, resting tremor, walking at the beginning of the hedge gait, less swinging upper limbs, common motion, extremity pathology (a). New diagnosis: Parkinson’s syndrome. Check blood and urine after admission