Whipple's disease.

摘要: Patient 1: A 55-year-old-man developed right facial twitching followed 6 months later by somnolence, blurred vision, and imbalance. He noticed that the spread to his neck tongue, family it persisted in sleep. then dysarthria complained of poor memory, change personality, malaise, intermittent fevers, increased sweating, impotence over ensuing months. On initial assessment 1 year after onset twitching, orientation, language were normal. was intermittently inattentive had marked resulting from rhythmic lingual retraction masticatory myorhythmia coinciding with contractions side face, neck, chest, arm. The irregularly left arm, leg. Vertical gaze limited, but improved oculocephalic maneuver. Saccades slow all directions. Pendular vergence oscillations more than eye (frequency = Hz) occurred synchronously skeletal (i.e., oculofacial-skeletal myorhythmia). Muscle tone, strength, sensation, deep tendon reflexes, plantar responses, postural stability His gait mildly ataxic.