精神病学病案剖析练习谜底(国外英文资料).docVIP

神经病学病案分析训练答案 Medical record 1 The patient, liu XX, male, 40, had a cold and headache before half a month, was treated with cold and relief. A week ago, the sight was blurred, the diplopia was weak and the movement was inconvenienced. The left upper extremity is weak, unnoted, two days of double lower limbs completely paralyzed, the left hand can not take things. No fever, no consciousness, convulsions, etc. [examination] cranial nerves: large circle such as double pupil, sensitive to light. Two eyes do not show. Its normal in other directions. The lateral frontal veins disappear, the eyelids are closed, and the two sides of the nasal mouth become shallow and shallow. No other brain abnormalities were detected. Left upper extremity muscle strength 4, right upper limb muscle strength 5 - grade. The lower extremities, the lower extremities, lower muscle tone. The lower part of the upper extremities of the upper extremities is lower, and the feeling is normal. The lower extremities of the lower extremities were decreased, and the feeling of the lower limb decreased. The calf muscle (+). The tendon reflex weakens. No pathologic reflection was induced. [in the waist] the pressure of the cerebrospinal fluid is 1.77 kPa (180 mmH2O). Eight white cells, 125 mg of protein, 45 mg of sugar, and 720 mg of chloride. Please diagnose the case, diagnose the main points, identify the diagnosis, identify the key points of diagnosis, need to improve the examination, the treatment principle Diagnosis: guillere-barre syndrome (acute inflammatory demyelination multiple neurosis) Key points: 1. Subacute onset of disease, the first half of the disease history Quadriplegic symmetrically flaccid paralysis (light upper extremities, heavy lower extremities) There are peripheral sensory impairments, Cranial nerve damage (facial nerve and abductor nerve) Cerebrospinal fluid indicating protein -- cell separation (normal cell count, elevated protein) Differential diagnosis and key points: Polio, pa