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#1
27.10.2005, 16:27
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82-year-old man
Âîò ìíå çàäà÷êà ïðèøëà â ðàññûëêå (ÿ â íåâðîëîãèè íè÷åãî íå ïîíèìàþ). Ìîæåò êîìó-íèáóäü áóäåò èíòåðåñíî:
BACKGROUND An 82-year-old man presents to the clinic with progressive difficulty swallowing and dysphagia over the last several weeks. He has been unable to eat food or drink water for the last 6 days and is thirsty. He denies odynophagia but reports that his speech has become slurred concurrently with his other difficulties. He denies having motor or sensory deficits, headache, fevers, urinary symptoms, malaise, or fatigue. On physical examination, the patient's vital signs are normal with a heart rate of 78 beats per minute and a blood pressure of 132/67 mm Hg. Pulse oximetry is 98% on room air. He has slurred speech. Examination of the head and neck reveals a normal oropharynx with intact tongue movements and a preserved gag reflex. However, the patient has bilateral, symmetric palpebral ptosis with a masklike face. In addition, he has to tilt his head back to look straight ahead. Because of an inability to lift his eyelids, he seems to be furrowing his eyebrows to compensate. The patient has normal motor strength, including strength in the extensors of his wrist and deltoids. He has intact sensation in his extremities and symmetric and normal deep tendon reflexes, and he can walk with no pronator drift. The patient has no difficulty breathing. What is the diagnosis? 
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#2
27.10.2005, 17:07
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Öèòàòà:
×òî êàñàåòñÿ äàííîãî ñëó÷àÿ. ß òàê ïîíèìàþ, äîïëíèòåëüíûõ äàííûõ íå áóäåò? À ïðàâèëüíûé îòâåò â ðàññûëêå òî åñòü? ÇÛ: Çàòî ÿ òî÷íî çíàþ, êàêîé áû ïîñòàâèëè äèàãíîç ó íàñ â ëþáîé áîëüíèöå  : ÖÂÁ: ÕÈÌ 2-3 (ÄÝÏ 2-3). Ñóáêîìïåíñàöèÿ. Öåðåáðàëüíûé àòåðîñêëåðîç . ÈÁÑ. Àòåðîñêëåðîòè÷. êàðäèîñêëåðîç. ÃÁ3.
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#4
27.10.2005, 17:22
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Öèòàòà:
 Sol. Piracetami 10,0 â äåëî ïîéäåò! À çà ÷òî åìó ÃÁ3?Ïî ñàáæó - ìîæåò îêóëîôàðèíãåàëüíàÿ ìûøå÷íàÿ äèñòðîôèÿ êàêàÿ
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#5
27.10.2005, 18:38
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Ïî ñàáæó - ìîæåò îêóëîôàðèíãåàëüíàÿ ìûøå÷íàÿ äèñòðîôèÿ êàêàÿ
__________________ Best regards, Àëåêñàíäð Òî÷íåå îêóëîôàðèíãåàëüíàÿ ìèàñòåíèÿ
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#11
27.10.2005, 22:08
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Öèòàòà:
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#12
27.10.2005, 22:10
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Âåðíî!
Myasthenia gravis [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Õîòÿ íà Oculopharyngeal muscular dystrophy î÷åíü ïîõîæå, à ïàöèåíò íà ôðàíöóçà. P.S. Sorry, îäîáðÿëêè íà ñåãîäíÿ êîí÷èëèñü. 
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#14
27.10.2005, 22:15
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Öèòàòà:
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Ëèíåéíûé âèä
