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患者男,44岁,因先后三次晕厥、咀嚼无力、吞咽困难、复视、新斯的明试验阳性于1977年6月16日入本院神经内科。查体除疲劳试验阳性外,无特殊发现。各项化验检查(肝功、肾功、血尿常规、血沉)均在正常范围。心电图正常,肝扫描、甲状腺同位素检查均在正常范围。胸部正(图1)位X线片,未见异常。双髋疼痛、步态螨跚,骨科会诊意见:弹响髋(关节韧带松弛所致),再次新斯的明试验:阳性。临床诊断重症肌无力,以吡啶斯的明60mg 3/日,服药后生活能自理。胸外科会
The patient was a 44-year-old man with a history of three episodes of syncope, chewing weakness, dysphagia, diplopia, and neostigmine. He was admitted to the Department of Neurology at the hospital on June 16, 1977. Except for positive fatigue tests, no special findings were found. Various laboratory tests (liver function, renal function, hematuria, and erythrocyte sedimentation rate) were within the normal range. The ECG was normal, and the liver scan and thyroid isotope examination were all in the normal range. Positive chest X-ray (Figure 1), no abnormalities. Pain in both hips, gait, orthopedic consultation opinion: snapping hip (caused by relaxation of the joint ligament), neostigmine test again: positive. Clinical diagnosis of myasthenia gravis, with pyridoxine 60 mg 3/day, can take care of themselves after taking medicine. Thoracic Surgery Association