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患者,女,40岁,已婚,农民。1987年8月与人闹矛盾后,出现不眠,阵发性言语、行为紊乱等症状。即入我院治疗,入院后躯体检查(一),诊断:癔症。用氯氮平(100mg)等药物治疗,20余天“痊愈”出院,出院后未服药,精神活动正常。1993年又因生气后出现言语混乱,疑人议论,全身麻木等症状,再次入院治疗。入院后躯体检查未查出异常。BEAM:轻度异常,精神检查:意识清,言语混乱,有片断的幻觉妄想,情绪不稳,行为幼稚。诊断:癔症性精神病,即应用小剂量氯氮平(25mgbid),阿普唑仑(0.8mgqn)治疗,次日症状即有缓解,入院第3日午休起床后患者突然晕倒,面色苍白,测BP:12/6kpa,脉搏弱,考虑为药物所致体位性低血压。即令其卧床,并输液观察,约1小时后血压升至14/10kpa。当晚患者未进食,问话不答。第4日查房时,发现患者右侧上下肢不能活动
Patient, female, 40 years old, married, farmer. In August 1987 after the contradiction with the people, there is no sleep, paroxysmal speech, behavioral disorders and other symptoms. Into our hospital treatment, after admission physical examination (A), diagnosis: Hysteria. Clozapine (100mg) and other drugs, more than 20 days “cured” discharged, no medication after discharge, mental activity was normal. In 1993, he was again admitted to hospital after being angry with speech disorder, suspicion and numbness and other symptoms. Physical examination after admission did not detect abnormalities. BEAM: Mild Abnormal, Mental examination: Consciousness, confusion, hallucination, emotional instability, childish behavior. Diagnosis: Hysteric psychosis, that is, the application of low-dose clozapine (25mgbid), alprazolam (0.8mgqn) treatment, the next day the symptoms are relieved, the first day after admission on the 3rd day after the patient suddenly fainted, pale, measured BP: 12 / 6kpa, pulse weak, consider the drug-induced orthostatic hypotension. Even if the bed and infusion observed, about 1 hour after the blood pressure rose to 14 / 10kpa. The patient did not eat tonight, asking questions. On the 4th check-in, found that patients can not move the upper right and lower limbs