zzzzhui 上午有关中美医学教育的比较让大家颇感兴趣，而DN案坛因为无人喝彩在月讯上已被废弃多时。为了引爆我们潜藏水底的深水炸弹们，已想的各种方法都收效甚微，那就何妨再来一个更馊的试试：俺开个周六病案分析论坛好不好？以后将以连载形式于每周六逐级释放某病案信息供大家在此磨脑用。请大家多多鼓掌、多多捧场啊！

Case 1  (part 1)

The patient was a 43-year-old, right-handed woman who presented in 1991 with a 1-year history of intermittent paresthesias in both hands.  This was not accompanied by numbness or weakness and the paresthesias intensified over the 6 weeks prior to her admission.  In the month prior to admission, she began to experience paresthesias of the right leg and a sensation of heaviness in both legs.  She had trouble keeping up with her young children and had a tendency to drag the right leg.  She also developed paresthesias in the perineal region without any disturbance of bowel or bladder function.  The patient thought her memory was unaffected, but she acknowledged that she did not feel mentally clear.  She had no headaches, visual or bulbar symptoms and no back pain.