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患者,男,42岁,农民。因四肢麻木、震颤2月余,4天来加重伴复视、反应迟钝、行走不稳,于1996年10月24日入院。既往有酗酒史10余年,每日平均500克左右。2月前出现四肢末端麻木,伴时有蚁行感,有轻微震动,并逐渐加重。4天前视物成双,反应迟钝,行走不稳,体检:T 37℃,P 88次/分,R 21次/分,BP 20/12kPa。神志清,表情淡漠,反应迟钝,记忆力及计算力明显减退。消瘦。全身皮肤干燥无弹性。双瞳孔约0.3cm,光反应灵敏,左眼外展不全。四肢有不自主细小震颤,肌肉轻度萎缩,肌力Ⅳ级,肌张力正常,四肢腱反射减低,病理反射未引出。快复轮替动作笨拙,误指试验阳性,跟膝胫试验阳性,直线行走不能。四肢末端对称性浅感觉减退。血沉35mm/h;肝功能正常;HBsAg阴性,血
Patient, male, 42 years old, farmer. Due to limb numbness, tremor more than 2 months, 4 days to aggravate with diplopia, unresponsive, unstable walking, on October 24, 1996 admission. Past history of alcoholism more than 10 years, an average of about 500 grams per day. Two months ago appeared extremities numbness, accompanied by a sense of ants, a slight vibration, and gradually increased. 4 days ago as a double, unresponsive, unsteady walking, physical examination: T 37 ℃, P 88 beats / min, R 21 beats / min, BP 20 / 12kPa. Conscious, apathetic, unresponsive, memory and computational power decreased significantly. thin. Whole body skin dry and inelastic. Double pupil about 0.3cm, light sensitive, left eye abduction. Limb involuntary minor tremor, mild muscle atrophy, muscle strength grade IV, normal muscle tone, reduced limb tendon reflex, the pathological reflex did not lead. Fast reincarnation clumsy move, false positive test, positive test with the knee shin, straight walking can not. Symmetry of extremities shallow feeling of diminished. ESR 35mm / h; normal liver function; HBsAg negative, blood