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例1,男,40岁。发热5天,双眼眶及颞侧持续性疼痛,陈发性加剧伴恶心呕吐。热退后,头痛减轻,出现右眼睑下垂。病程中无昏迷及四肢瘫等表现。体温正常,Bp16.0/10.7kPa(120/80mmHg)。神志清醒,左眼睑完全下垂,上提受限,眼球各方向运动障碍,瞳孔6mm。直接、间接对光反射消失,眼底未见异常。右眼正常。Hb110g/L,WBC1.1×10~(10)/L,N0.93,L0.07,尿糖阴性,血糖5.4mmol/L。腰穿,压力1.4kPa(145mmH_2O),CSE WBC1.3×10~7/L,生化检查正常。入院后口服地塞米松,肌注青霉素,一周后头痛消失;三周后左眼裂可开大3mm,眼球运动有改善,瞳孔恢复正常,对光反射正常。随访三个月症状完全恢复。
Example 1, male, 40 years old. Fever five days, persistent pain in both eyes and temporal and temporal, exacerbated with nausea and vomiting. Heat back, headache relief, there is the right eyelid ptosis. No coma in the course of the disease and quadriplegia and other performance. Body temperature is normal, Bp16.0 / 10.7kPa (120 / 80mmHg). Consciousness, the left eyelid completely drooping, limited lifting, eye movement disorders in all directions, the pupil 6mm. Direct, indirect reflection of light disappeared, no abnormalities in the fundus. Right eye is normal. Hb110g / L, WBC1.1 × 10 ~ (10) /L, N0.93, L0.07, urine negative, blood glucose 5.4mmol / L. Waist wear, pressure 1.4kPa (145mmH_2O), CSE WBC1.3 × 10 ~ 7 / L, biochemical tests were normal. After admission, oral dexamethasone, intramuscular injection of penicillin, headache disappeared after a week; three weeks after the left eye crack can open large 3mm, eye movement has improved, the pupil returned to normal, the light reflex normal. Three months follow-up symptoms completely restored.