患者,男,55岁,二年前因多食、多尿,在某医院诊断为糖尿病。经间断服用降糖灵等药物病情未能控制。近10个月来,自觉头昏、头胀、全身乏力、尿淋漓、大便失禁。近4个月来,逐渐出现走路不稳.有时跌倒,喝水呛咳,吞咽困难,言语不清,手颤抖不能写字,阳萎。查体:神志清楚,表情呆板,吟诗样语言。脑神经未见异常。四肢肌力Ⅴ级,肌张力略强。步态蹒跚,指鼻试验阳 Patient, male, 55 years old, diagnosed with diabetes in a hospital two years ago because of eating more and having more urine. After taking intermittent hypoglycemic and other drugs failed to control the disease. Nearly 10 months, consciously dizziness, head swell, generalized weakness, urine dripping, fecal incontinence. In the past 4 months, walking gradually instability, and sometimes fall, drink cough, difficulty swallowing, vague words, hand trembling can not write, impotence. Physical examination: conscious, dull expression, poetry-like language. No abnormalities in the cranial nerves. Grade Ⅴ limb muscle strength, muscle tone slightly stronger. Gait hobbled, finger nose test positive