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患者68岁,女性,既往身体健康,因舌和双手细震颤及行动迟缓3个月于1987年11月入院。体检发现:全身肌张力轻度增高,面部无表情,缓慢步态,双手和唇轻度静止性震颤(频率14～16次/分)智力正常。排除了神经药物中毒或正常颅压脑积水等引起帕金森综合征的其他因素。按照Hoehn和Yahr评价标准,诊断为帕金森氏病Ⅱ期,采用L-DOPA和每天500mg羟苄丝肼(benserazide)治疗3个月,震颤症状加重,继每天加用100mg邻甲苯海拉明(Orp-henadrine)仍无任何好转,此后,在10个月的观察中发现病人状况进行性恶化。1988年12月四肢呈现严重震颤,从而影响了病人所有日常活动,后增加两种药物剂量,但仍未使症状改善,一个月以后,即1989年1月病人开始出现间歇发烧,右额部疼痛,没有视觉障碍或眩晕。实验室检查示轻度低色素性
The patient, 68 years old, female, formerly healthy, was admitted to hospital in November 1987 after three months of tremor and slow movement of the tongue and both hands. Physical examination found: mild muscle tone increased, facial expressionless, slow gait, hands and lips mild rest tremor (frequency 14 ~ 16 beats / min) normal intelligence. Ruled out neurological drug poisoning or normal intracranial pressure hydrocephalus and other factors that cause Parkinson’s syndrome. According to Hoehn and Yahr evaluation criteria, the diagnosis of Parkinson’s disease Ⅱ period, the use of L-DOPA and 500mg daily benserazide treatment for 3 months, tremor symptoms aggravated, following the daily addition of 100mg o-Toluidine ( Orp-henadrine) still did not get any better, after which 10 months of observation found that the patient’s condition worsened. Extremities and limbs presented severe tremor in December 1988, which affected all daily activities of the patient. Two doses of the drug were added afterwards without any improvement in symptoms. One month later, patients started to have intermittent fever and pain in the right forehead in January 1989 No visual impairment or dizziness. Laboratory tests showed mild hypopigmentation