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患儿,女,9岁。因发热4天,双下肢无力伴排尿困难1天。既往体健。体检:神萎,颈软,心肺(-),肝脾未及,膀胱区充盈,两下肢肌张力Ⅲ°,胸7以下感觉减退,腹壁反射消失,双膝反射迟钝。余检查正常。实验室检查:血常规、尿常规、中段尿培养、腹平片及肾脏B超检查均正常。血钾、血钠、血氯化物亦正常。血沉34mm/h、血尿素氮16.6mg/dl、肌酐1.5mg/dl、尿爱迪氏计数:红细胞60,000,白细胞300,000。脑脊液:蛋白(-),细胞数23,糖40～50mg/dl,脑脊液胶金试验异常,呈初带型,IgG6.3mg/dl。左眼眼底检查为视神经乳头炎,2周后复查左眼视神经萎缩,其余正常。双眼视野检查,左眼颞侧偏盲伴中心盲点扩大,右眼正常。听觉脑干诱发电位正常范围。住院经过:患儿发病较急,入院第二天,双下肢不能站稳不能行走,於入院第18天,患儿前额痛伴左
Children, female, 9 years old. 4 days due to fever, weakness of lower extremities with dysuria 1 day. Past physical health. Physical examination: Shen Wei, neck soft, cardiorespiratory (-), liver and spleen not yet filling the bladder area, lower extremity muscle tension III °, chest 7 below the feeling of diminished abdominal reflex disappeared, knees reflex dull. I checked normally. Laboratory tests: blood, urine, urine culture, abdominal plain film and kidney B-ultrasound were normal. Blood potassium, serum sodium, blood chloride is also normal. Erythrocyte sedimentation rate 34mm / h, blood urea nitrogen 16.6mg / dl, creatinine 1.5mg / dl, urinary Aidi count: red blood cells 60,000, white blood cells 300,000. Cerebrospinal fluid: protein (-), cell number 23, sugar 40 ~ 50mg / dl, cerebrospinal fluid gold and gold test was abnormal, was first type, IgG6.3mg / dl. Left eye fundus examination for optic nerve head inflammation, 2 weeks after the review of left optic nerve atrophy, the rest of normal. Binocular visual field examination, left eye temporal hemianopsia with blind center expansion, right eye normal. Auditory brain stem evoked potentials normal range. After hospitalization: children with acute onset, admission the next day, can not stand both lower extremities can not walk, on the first 18 days of admission, children with prefrontal pain with the left