Due to the influence of disease factors such as pediatric rabies, mania alternating with lethargy and cranky abnormality during attacks occur. Rabies (rabies) is a zoonotic acute infectious disease of the central nervous system caused by rabies virus. The main clinical manifestations are characteristic mania, fear and agitation, fear of wind and water, salivation and pharyngeal muscle spasms, and eventually life-threatening paralysis. What are the diagnoses of diseases associated with alternating mania and somnolence? 1.Rabies-like hysteria Since rabies is a very scary disease, some hysterical patients imagine that they suffer from this disease after exposure. This is manifested by a feeling of throat constriction from time to time after being bitten by an animal, difficulty drinking and excitement, but no fear of wind, salivation, fever and paralysis. Through hinting, persuasion, and symptomatic treatment, the patient’s condition no longer develops. 2, tetanus The early symptoms of tetanus are tightness of the teeth, later appearing bitter smile face and corneal arch, but not fear of water. Tetanus involved muscle groups in the interval of spasm still maintain high muscle tone, while rabies patients of these muscle groups in the interval is completely relaxed. 3, viral meningoencephalitis There is obvious intracranial hypertension and signs of meningeal irritation, with significant alterations in mental status, and cerebrospinal fluid examination helps to differentiate. 4, poliomyelitis Paralytic poliomyelitis is easily confused with paralytic rabies. The disease has a two-way febrile onset, with asymmetric flaccid paralysis of bilateral limbs, no hydrophobic symptoms, and more pronounced myalgia.