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一位69岁患者的神经症状加重已有21年颈部 X 线检查为骨赘、脊椎狭窄。手术后病人呼吸困难、左声带麻痹、肌肉无力呈扩大趋势,尤其在左侧,语言不清、生活不能自理,吞咽困难。经神经专家会诊为肌萎缩性脊髓侧索硬化(ALS),神经生理学研究给予了证实。脑部、索带核磁共振成像检查皆阴性、血清试验表明 Lyme 病和梅毒阴性。因有病人反映服用头孢三嗪(Ceftriaxo-ne)后,这类症状有所改善,故我们对该病人给予头孢三嗪治疗,每日2 g。治疗3周后,病人生活可以自理、语言改善、吞咽自如。
Neurological symptoms in a 69-year-old patient have been aggravated for 21 years. Neck radiographs are osteophyte and spinal stenosis. Patients with postoperative respiratory dysfunction, left vocal cord paralysis, muscle weakness showed an upward trend, especially in the left, the language is not clear, life can not take care of themselves, swallowing difficulties. Consultations by neurologists for amyotrophic lateral sclerosis (ALS), neurophysiological studies confirmed. Brain, cable MRI examination were negative, serum tests showed Lyme disease and syphilis negative. Because of the patient’s response to Ceftriaxo-ne, the symptoms improved, so we treated the patient with ceftriaxone 2 g daily. Three weeks after treatment, the patient’s life can take care of themselves, the language is improved, and swallowing freely.