1　病例报告例1 :患者男,5 1岁。因吞咽困难、声嘶2 d,四肢无力1 d于2 0 0 0 -0 7-2 4入院。入院前2 d声音嘶哑、吞咽困难和饮水呛咳,病前3～4d有咽痛,无发热,耳鼻喉科诊断“咽炎”,予抗炎治疗无好转。入院前1 d出现四肢无力,从肢体远端开始,不伴肢体麻木和尿便障碍。查体:双额 Case report 1: Patient male, 51 years old. Due to dysphagia, hoarseness 2 d, limb weakness 1 d at 2 0 0 0 -0 7-2 4 admission. 2 days before admission, hoarseness, difficulty swallowing and drinking cough, sore throat 3 to 4 days before illness, no fever, otolaryngology diagnosis “pharyngitis”, anti-inflammatory treatment without improvement. 1 d before admission there limb weakness, starting from the distal limbs, without limb numbness and urinary problems. Physical examination: double amount