患者，男，39岁，因右手无力18d入院．入院前18d无明显诱因感右手僵硬无力，握笔不紧，一周后握不住筷子，症状进行性加重，不能从事日常精细动作，入院前两天曾觉右臂尺侧肌肉抽搐，几秒钟后消失。发病以来无头痛头晕，无恶心呕吐，无意识障碍。查体T36．SC、P70次／min、R18 Patient, male, 39 years old, admitted to hospital with 18 right hand weakness. 18d before admission there is no obvious incentive to feel stiff right hand, holding pen is not tight, a week later could not hold the chopsticks, progressive aggravation of symptoms, can not engage in daily fine movements, two days before admission, right arm ulnar muscle twitch, a few seconds After disappearing. No headache, dizziness, no nausea, vomiting, unconsciousness since onset. Physical examination T36. SC, P70 times / min, R18