Rebirth of Medicine Practices the World

"He is the main labor force in the family. He is usually very strong and can easily lift a load of one to two hundred kilograms. However, within a few hours after the onset of the disease, he was unable to do heavy work at all."

"Ever since I saw his illness, I was very nervous. I took him to our local hospital many times, saw many doctors, and did many tests, but there was no result and his condition did not improve at all."

"He is indispensable for the farm work at home, and he refuses to stop. I have to accompany him to the fields to take care of him. Over time, I discovered a pattern. When the weather is cool and cool, there is basically no illness. When the sun is strong, almost every day

I get sick every time."

The patient's wife described the illness very clearly and vividly.

"Has he ever been like this before?"

"No."

"Aren't your hands and feet twitching every time you have an attack?"

"No, never."

"Have you ever had a seizure at home?"

"No, I've never had an attack at home."

"Does he usually eat a lot?"

"Not much. From the onset of the disease to now, there is nothing abnormal when he eats at home."

"Okay, thank you!" After hearing this, Lin Lin already knew what she was saying.

Lin Lin routinely performed a complete set of nervous system physical examinations in order to let the interns see how a complete nervous system physical examination should be performed.

Yes, Lin Lin did not miss any opportunity to teach the students. Whether the students can learn Lin Lin's skills depends on their understanding and "cultivation".

Back in the office, Lin Lin looked relaxed.

"Okay, let's discuss it, let's start with Dr. Dong." Lin Lin got straight to the point.

"Okay, let me tell you my opinion." Dong Huayu was very calm.

"The patient is a prime-age male. It has been more than 4 years since the onset of the disease. He has a stereotyped attack. Each attack has a fixed trigger, which is exposure to sunlight."

"Currently, no abnormalities have been found in the patient's physical examination and auxiliary examinations."

"Based on the medical history, the patient has a seizure disorder. At such an age and with such obvious seizures, I consider epileptic seizures to be the most likely possibility."

"However, the patient has had electroencephalograms done several times, but no abnormalities were found. He also had magnetic resonance imaging of the head several times, and there were no abnormalities."

"It has been more than 4 years, and the patient's seizure pattern has not changed. At this point, I am still not sure. I am not sure it is an epileptic seizure."

"Therefore, it is necessary to rule out whether this patient has a hysterical attack, or whether it is a hypoglycemic attack, which can lead to relief by eating a large amount of food."

"I basically agree with Dr. Dong's opinion. I am more inclined to suffer from hypoglycemia. If possible, should I do a glucose tolerance test?" Li Yun'e couldn't say anything more.

"When I was doing ward rounds, I also tended to think that epileptic seizures were more likely. I just felt very confused. For more than 4 years, the patient was limited to one type of seizure, and all examinations were normal. It is really difficult to draw a conclusion."

"Once a diagnosis of epilepsy is made, the patient must take medication for more than two years. Therefore, we have never dared to make this diagnosis easily." Although Ding Feng is fickle, she is very careful in her work.

"I have been practicing medicine for decades and have seen many types of epileptic seizures, but I have never seen this form of epilepsy. Therefore, it is better to be cautious when making a diagnosis of epilepsy." Ling Xiaoyun's level has long since stopped.

Can't move forward anymore.

"This patient, I prefer Director Ding's opinion, considers it more likely that he has epilepsy. As for the next step of diagnosis and treatment, we can only place our hope in our almighty Dean Lin." Ye Xiu's eyes were filled with confusion.

Lin Lin is omnipotent.

"Everyone had a thorough discussion. It can be seen that everyone read a lot of books and consulted a lot of information. Dr. Dong, in particular, deserves praise for his way of thinking about the problem."

"This patient is indeed special, but it is precisely because of his specialness that I can find the basis for diagnosis."

"The patient suffered from the disease in middle age, and the attacks were very regular. He would only have attacks when he went to work in the fields on sunny days. In fact, we can think about this problem in a more divergent way. If he is allowed to go outside to bask in the sun on a sunny day,

Will it happen soon?"

After everyone listened, they nodded frequently.

"Yes, why didn't we think of this? Dean Lin, you are so amazing. You can reveal the essence of the problem in just one sentence." Ding Feng suddenly realized.

Yes, isn't this a good induction method? Why didn't they think of it? Precisely because they didn't think of it, many inspections cannot be carried out in a targeted manner.

"Yes, Dean Lin, with just one word, we will know what to do next." Dong Huayu became excited.

"Well, Doctor Dong, tell me what you think."

"We can contact the EEG laboratory, induce him to have a seizure, and immediately perform an EEG examination on him. At this time, the positive rate of the examination will be greatly improved." Dong Huayu said excitedly.

"Okay, not bad." Lin Lin praised it.

"Dean Lin, what do you mean, there is no problem in diagnosing epilepsy for this patient." Ling Xiaoyun asked.

"Yes, I think there is no doubt that this patient is diagnosed with epilepsy. He can be diagnosed with complex partial seizures, which some also call limbic seizures."

"I have a few questions to ask Dean Lin." Li Yun'e's interest also increased.

"Teacher Li, please speak."

"First, there are many triggering factors for epilepsy, such as staying up late, drinking, sound and light stimulation, etc. Why does this patient only develop the disease when exposed to sunlight? If it is related to light, it also occurs on cloudy days.

Guang, why don’t you get sick?”

"Second, for such a long time, without any anti-epileptic treatment, the patient's seizure type has not changed. Why is this patient's seizures so stereotyped?"

"Third, if it was an epileptic seizure for such a long time, why would every EEG examination be normal?"

"Also, Director Lin does not suspect that this patient's attack is related to hypoglycemia? These questions are where I am confused. I would like to ask Director Lin to help answer them."

"Teacher Li's questions are very good. Each question touches on the 'pain points'. I guess this is also a question that many people have in mind. I am also confused by some of the questions. However, I am willing to discuss and discuss with you.

discuss."

"First of all, regarding the causes of epilepsy. When Teacher Li asked the question just now, he already mentioned the common causes."

"These inducements are all common, and they are the ones we see most in books and literature. In addition to these common ones, how many rare inducements are there that we have never seen or even know about? I think

, this is a worldwide problem.”