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Nervous system diseases Lecture Notes Question: ...

. Incidence of any age can be, but more common in young adults. Can move heavy physical potential, diet or emotional fullness,[link widoczny dla zalogowanych], such as the incentive. May have before the onset limb soreness, numbness, polydipsia, sweating, looking poke red forequarters symptoms. Often wake up in the morning or the middle of the night suddenly found sleeping limb weakness - Day Ni conscious minority who onset. Usually begins with lower limb weakness, resistance, and after crossing the upper limbs, proximal legs, heavy, symmetrical. In mild sick, weak or is likely to be limited to a ~ limbs. Symptoms often made at high 1 to 2 hours slightly. Consciousness is always clear and can attack paralyzed limbs may have mild swelling, when a solid sense of touch, may have crouching limb pain and sensory dysfunction, but the objective sense of accessibility Liang Wan feeling was normal. Decreased muscle tone, tendon buildings disappeared or decreased shoot. To the column head and facial muscles are not involved. Attack to be associated with plant God hydroxyl dysfunction, manifested as thousands mouth, pale skin, heart rate, irregular heartbeat, high blood pressure or decreased and so on. Usually last a few hours or 1 to 2 days can be restored Ran the recovery process rarely more than 4 days is quite fast, but 1,2 hours, the first is often the first invasive muscle paralysis rehabilitation. Recovery in the muscle of patients with polyuria, big stick in and paralysis from the pain and stiffness of muscle. Were paralyzed with intermittent seizures. Yao rates vary, significant differences between several times a day shorter, just attack 1-2 times life to the elderly. Usually frequent episodes in winter. (B) hyperkalemic periodic paralysis by the Tyler thousands Emirates first reported in 1951, 1956 Gamstorp said the disease is inherited limb weakness mostly in l0 pension before the age of onset,[link widoczny dla zalogowanych], men more common. Onset often during the day, may, sports, travel or drinking by the potassium-rich foods such as induced. Gravis and hypokalemic periodic paralysis symptoms are similar, but opposite changes in serum potassium, the symptoms appear in the serum potassium higher than the normal pair. Paralysis of one is not serious, proximal limb and trunk muscles affected by the easy to be a ship rigidity and spastic myalgia. Weakening or disappearance of tendon reflexes involved. Village of facial muscles may also be affected. Paralysis usually in small domestic 2l a0 minutes to recover. Park, who attack vary the amount of prison. This type of higher than normal serum potassium, increased excretion of potassium in feces, a special ECG changes. T transition showed changes of early high point. (C) of the normal potassium sodium reaction, also known as periodic paralysis periodic paralysis normal potassium. Onset before the age of 10, more common at onset,[link widoczny dla zalogowanych], induced solid and similar hypokalemic periodic paralysis, muscle paralysis lasted longer. Patients may have limb paralysis and chewing muscle weakness, cough pier construction field. Fourth,[link widoczny dla zalogowanych], laboratory tests were hypokalemic periodic paralysis, seizures decreased serum potassium, urinary potassium also reduced serum creatine kinase B subunit increased in words, ECG changes were hypokalemic. Hyperkalemia periodic paralysis who attack increased serum potassium levels, increased potassium in feces, ECG was high-K of the change. Normal potassium periodic paralysis who attack the blood, urine potassium normal and increased sodium feces. V., diagnosis based on history, clinical symptoms, serum potassium, electrocardiogram changes, generally for diagnosis. Diagnosis of hypokalemic paralysis are trapped on time, can be induced test. Is in the morning fasting oral glucose powder 206 ~ 300g, subcutaneous insulin 20u, a half hour later without】】 JL unable to attack, may be such as intravenous injection of 60ml with 50 glucose and inject insulin 10u diagnosis of periodic paralysis hyperkalemia difficulties, it can be. ① potassium load test, I observed that oral administration of potassium can induce weakness. Specific side link is 4 ~ 5g of oral potassium chloride, such as the lame-based patients, after serving there 30 to 90 minutes, weakness, a few minutes to an hour reached the peak, sustained 20-1 minutes, ② exercise-induced test, the patient pedal bicycles, car plus a 400 ~ 750kg resistance for 30 to 60 minutes after stopping 3O minutes, such as muscle weakness induced by elevated serum potassium can be diagnosed with the disease} @ cold provocation test, the forearm immersed in 11 ~ 23 ~ C water, such as for patients, 20 to 30 minutes I induced muscle weakness, stop dipping in cold water for 10 minutes after the resumption. Sixth, treatment of hypokalemic periodic paralysis may give thousands of oral potassium chloride 10 or 20, potassium citrate solution 30ml, every 2 to 4 hours to repeat the dose. Reduction of disease, such as improved gradually. Severe cases can be intravenous. Periodic paralysis hyperkalemia sweet wine can also be calcium or calcium chloride intravenous glucose or glucose plus insulin infusion to lower blood potassium. Potassium can also be used furosemide row. Normal potassium periodic paralysis, could be given, ① calcium,[link widoczny dla zalogowanych], 1O grape Mo calcium 10ml, 1 to 2 changes per day, intravenous; or calcium 0.6 ~ 1.2g / d, l ~ min 2 King orally. ② carbonic anhydrase inhibitors, oral vinegar, ammonia amide 0.25 ~ 0.5g / d. @ Na, day day service l0 ~ 15g of salt, if necessary, use of sodium chloride wide open pulse points {Ji (Continued) [Cheng mushroom police shake]
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