病例:男,52岁,农民.因反复发作性昏迷2年,加重4天入院。2年前首次发病是在晨间发现软弱无力,不言语,两眼凝视,呼之不应,即送医院,诊断为“癔病”,静注葡萄糖液后1小时恢复。一年半前在回家途中又有类似发作,口服糖水后缓解。以后发作间歇期逐渐缩短至1月、半月,直至1周发作2次。多在饥饿或受精神刺激后发病.近半年来发作时常伴有四肢抽动,有时伴尿失禁,瞳孔散大,10分钟左右可缓解。入院前4天卧床不起,表情淡漠,不思饮食,尿便失控。门诊以“意识障碍待查,散发脑炎?结核性脑膜炎?”收入院。内 Case: Male, 52 years old, farmer. Due to repeated episodes of coma for 2 years, aggravating 4 days admission. 2 years ago, the first incidence was found in the morning weak, nonverbal, staring at both eyes, call it should not be sent to the hospital, diagnosed as “hysteria”, 1 hour after intravenous glucose recovery. A year and a half ago on the way home there is a similar attack, relieved oral sugar. Intermittent episode after the period gradually reduced to January, half months, until 1 week attack 2 times. More in hunger or by the spirit of the disease after the onset of seizures in the past six months often accompanied by limbs twitching, sometimes with incontinence, mydriasis, 10 minutes or so can be alleviated. Bedridden 4 days before admission, apathy, do not think diet, urine will be out of control. Out-patient to “unconsciousness pending investigation, encephalitis distributed? Tuberculous meningitis?” Income homes. Inside