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 is the cause and course of alternating mania and somnolence? The main cause of alternating mania and lethargy is rabies, and the pathogenesis of rabies can be divided into the following three stages: 1. Small amount of extra-neural multiplication period: After the virus invades the skin or mucous membrane from the bite site, it first multiplies in small amount in the transverse muscle cells of the local wound, and invades the nearby peripheral nerves by binding to the acetylcholine receptors of the neuromuscular junction. From the local wound to the invasion of peripheral nerves is not shorter than 72 h. 2. Invasion of central nerve from peripheral nerves: The virus spreads centripetally along the axons of peripheral nerves at a rate of about 5 cm/d. After reaching the dorsal root ganglion, it begins to multiply in large quantities, then invades the spinal cord and then spreads to the entire central nervous system. It mainly invades neurons in the brainstem and cerebellum. However, it can also terminate at a certain site in the process of spreading, forming a special clinical manifestation. 3, from the central nervous system to the organs: that is, the virus from the central nervous system to the peripheral nerves eccentric spread, invading various tissues and organs, especially the salivary glands, tongue taste buds, olfactory nerve epithelium and other places where the most virus. Due to the damage of vagus nucleus, swallowing nucleus and hypoglossal nucleus, spasm of respiratory muscle and swallowing muscle may occur, and patients clinically show symptoms such as hydrophobia, dyspnea and dysphagia; sympathetic nerve is stimulated to increase salivation and sweating; damage of vagal ganglion, sympathetic ganglion and cardiac ganglion may cause dysfunction of cardiovascular system and even sudden death of patients.