作者报告1例结脑患儿,于起病初期出现偏身颤搐和偏身舞蹈症,并指出,脑膜炎患者出现锥体外路运动具有重要的诊断价值。病例2.5岁,男性,先天愚型患儿,因发热、呕吐和兴奋10天入院。检查神经系统无阳性体征和异常运动。CSF中WBC331/μl,多核细胞10%,淋巴细胞88%,单核细胞2%,蛋白105mg/dl,糖22mg/dl。于入院第4日出现全身抽搐、发热、左侧偏瘫,右侧肢体呈偏身颤搐及舞蹈样运动。3周后从CSF中检出结核杆菌。CT检查提示非交通性脑积水,右侧基底节可见一限局性低密度的缺血性梗塞区。10日后复查CT提示脑积水加重,并于双侧基底节及颞叶和顶叶白质出现新的低密度区,53天出院时,神志清,但仍遗留左侧偏瘫和右侧锥体外路运动。讨论结脑的早期诊断较困难。结脑可出现各种类型的锥体外路运动,据有人统计可达13.3%,并且可能是结脑的最初部分症状。其发病机制可有多方面 The authors report a case of tuberculous meningitis in children with early onset blind deflexion and partial chorea and pointed out that meningitis in patients with extrapyramidal movement has an important diagnostic value. Case 2.5 years old, male, Down’s syndrome, admitted to hospital for fever, vomiting and excitement for 10 days. Check the nervous system without positive signs and abnormal exercise. CSF, WBC331 / μl, multinucleated cells 10%, lymphocytes 88%, monocytes 2%, protein 105mg / dl, sugar 22mg / dl. On the 4th day of admission, convulsions of the whole body, fever, left hemiplegia, hemifacial twitching and dance-like exercise on the right limb were observed. Mycobacterium tuberculosis was detected from the CSF after 3 weeks. CT examination showed non-communicating hydrocephalus, the right basal ganglia showed a limited number of ischemic ischemic infarction area. 10 days after the review of CT prompted hydrocephalus increased, and in the bilateral basal ganglia and temporal lobe and parietal white matter appeared in the new low-density area, 53 days discharged from the hospital, conscious, but still left left hemiplegia and right lateral cones movement. It is difficult to discuss the early diagnosis of tuberculosis. There are various types of extrapyramidal motor movements in the tubercles, accounting for up to 13.3% of the population, and may be the first symptom of tuberculous meningitis. Its pathogenesis can have many aspects