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患儿女,6岁。因头痛10天,口角歪斜、视物模糊5天,于1988年6月13日入院。患儿10天前起间歇性头痛,以左前额为主,能忍受。每次发作持续4～5分钟自行缓解,不伴发热、呕吐及抽搐。5天前出现口角左歪,左眼视物模糊和复视,左侧少量鼻衄3次。体检:神志清,反应好。左眼1m指数不清,视力减退,左眼睑下垂,左瞳孔略大于右侧,光反射消失,左眼球向上、下、外、外上、外下运动差。左咬肌萎缩,下颌左歪,闭眼紧,额纹存在,鼻唇沟等深,伸舌不偏,讲话带鼻音。未及肿大浅表淋巴结。颈无抵抗。心肺听诊正常。肝脾肋下未及。肢体活动无障碍,四肢肌力V级,病理反射阴性。实验
Children with children, 6 years old. Due to headache for 10 days, skewed mouth, blurred vision for 5 days, in June 13, 1988 admission. Children with intermittent headache 10 days ago to the left forehead, can tolerate. Each episode lasts 4 to 5 minutes to ease itself, without fever, vomiting and convulsions. 5 days ago left crooked mouth left eye blurred vision and diplopia, left a small amount of epistaxis 3 times. Physical examination: conscious, good response. Left eye 1m index is not clear, vision loss, left eyelid ptosis, left pupil slightly larger than the right, light reflex disappears, the left eyeball up, down, outside, outside, outside the poor movement. Left masseter muscle atrophy, mandibular left crooked, eyes closed tight, frontal pattern exists, nasolabial fold and other deep, stretch the tongue is not partial, speech with nasal. Not swollen superficial lymph nodes. Neck without resistance. Cardiopulmonary auscultation normal. No time under the ribs and ribs. Physical activity barrier, V-limb muscle strength, pathological reflex negative. experiment