When doctors have a simulated operating room

The cause of epilepsy is mainly divided into two types, one is idiopathic epilepsy, which is hereditary.

The other is secondary epilepsy, which has more secondary causes.

For example, epilepsy caused by trauma, such as car accidents, heavy blows, etc.; there is also epilepsy caused by encephalitis and cerebrospinal fluid infection; or epilepsy caused by intracranial tumors; or epilepsy caused by drug poisoning, parasitic infection, etc.

The former has no obvious changes in the brain parenchyma, but the latter has obvious changes in the brain parenchyma.

Therefore, the significance of EEG for idiopathic epilepsy is greater than MRI.

Generally, within half an hour after the onset of epilepsy, it is the peak period of abnormal discharge of brain waves.

At this time, EEG is one of the most effective means to diagnose epilepsy.

The longer the time is delayed, the brain waves will return to normal by themselves. At this time, you will not see any positive reaction when you do an EEG.

But the patient Chen Fang mentioned had an EEG as soon as he came to the hospital, and it was only about half an hour after the onset of the disease? ?

Why is the EEG reaction so unclear? ?

It's very strange!

The patient's mother has epilepsy, so Chen Fang's diagnosis at the first time was correct, and he did suspect hereditary epilepsy.

But the EEG result is different from the diagnosis. Which link is wrong?

Traumatic epilepsy can be diagnosed immediately by taking an MRI, because the brain is seriously injured.

But this kind of hereditary epilepsy has no obvious substantial brain lesions. The EEG has not found anything, and the MRI is even harder to see.

Zhang Yi zoomed in and out on the phone screen.

He looked at the MRI results again and again. Although he already had the help of a super awesome system, he really couldn't see any substantial problems with the patient's brain.

It's really weird!

No wonder Chen Fang was confused. He himself felt that the test results were a bit shady.

Zhang Yi frowned, thought for a while and replied to Chen Fang:

"Ask the family of this child again to see if there are any other genetic diseases or changes in the child's own eating habits.

If you can't find the problem with epilepsy, then start looking in other directions, don't stick to one direction."

"You think it's not epilepsy? But the symptoms of his admission to the hospital are epileptic seizures, right..."

"Then just do a 24-hour EEG test, and also check the direction of drug screening and food poisoning.

Ask the family what specific epilepsy control drugs they usually give him to see if the family members are taking them randomly.

Also, haven't the results of the patient's blood test come out yet? What's the blood sugar level?"

Just as Zhang Yi asked, the hot stewardess next to him walked to Zhang Yi with a smile and said:

"Excuse me, sir, the plane is about to take off, please turn off your phone or switch it to flight mode~"

Boom~

The sound of the plane engine also rang in Zhang Yi's ears instantly, and then the plane began to taxi slowly.

Zhang Yi looked at the flight attendant apologetically:

"Okay, thank you for reminding me."

Then Zhang Yi sent a message to Chen Fang: "The plane took off, I'll talk to you after I land."

After that, he turned his phone to flight mode.

...

At the same time.

Emergency Department of Union Hospital.

"Blood sugar? Yes! The blood test results haven't come out yet? Yunhui? Did you send Yunhui's blood to the laboratory just now?"

Seeing Zhang Yi's message, Chen Fang hurriedly asked.

"Sent it, or I'll call them to urge them. I said it's an urgent check."

"Okay, urge them!"

Chen Fang's face revealed a trace of anxiety.

It has been a while since I came to Union Hospital. Recently, Chen Fang began to independently treat patients in the emergency department.

This little boy is the patient that Chen Fang took over himself.

At first, I thought it was epilepsy, and the patient did feel better after taking a shot of diazepam.

Unexpectedly, he started to twitch again.

And the test results did not look like epilepsy, which made Chen Fang very puzzled.

He asked Mao Xiaoyuan for help, but Mao Xiaoyuan told him to ask Zhang Yi.

But Zhang Yi suspected that it was not epilepsy.

Convulsions, fainting, confusion, and family inheritance.

How to analyze that he has hereditary epilepsy? ?

Could it be... hypoglycemia? ?

The main symptoms of epilepsy are convulsions and confusion.

But... convulsions and confusion are not just epilepsy.

For example, intracranial injury, substantial brain damage, central nervous system injury, etc.

Nerve infection, drug poisoning, cerebrovascular disease, cerebral ischemia and hypoxia, etc. can all lead to convulsions and coma.

Even a small hypoglycemia can cause patients to convulse and coma.

"Yes, Zhang Yi is right. Since the results of MRI and EEG are not obvious, we can continue to improve other examinations while testing EEG for 24 hours, so that nothing will be delayed."

As he said, Chen Fang followed up with the doctor's advice.

24-hour EEG test, blood drug test, intracranial cerebral angiography.

Suddenly, the nurse named Yunhui came over in a hurry:

"Doctor Chen, Liang Yu's blood test results are out, can you check the computer?"

"Okay!"

As a result, Chen Fang clicked on it and when his eyes scanned the blood sugar value column...

He exclaimed, wow!

He immediately reached out and patted his thigh root!

The force almost swollen his hand!

"Oh my gosh! Mao Xiaoyuan, come and have a look!" Chen Fang looked at Mao Xiaoyuan with a helpless and somewhat relieved expression and said.

"What's wrong?"

Mao Xiaoyuan also hurried over. After looking at the computer, he couldn't help but roll his eyes and said helplessly:

"Damn it! After all this time, it's hypoglycemia??! This is really... nonsense!"

The test results showed that the blood sugar was only 2.4!

The normal fasting blood sugar index is 3.9-6.1mmol/L, and one hour after a meal is 6.7-9.4 mmol/L.

This boy is only 2.4!

No wonder he fainted and convulsed!

Really...

It should be said that the family member's statement of epilepsy is really a bit misleading.

If it weren't for the glucose in the liquid just now to replenish the blood sugar, who knows what the child is like now.

I can only say that fortunately...

He accidentally replenished some sugar water and saved his life!

Immediately, Chen Fang changed the doctor's order and ordered several bottles of glucose and 24-hour blood sugar testing. In addition, he called the family members into the office.

In the office, the family members looked quite simple, but they were really stupid...

Chen Fang sighed helplessly and motioned them to sit down.

"Doctor, my son... doesn't he have epilepsy?" the boy's father asked.

Chen Fang showed the printed blood test results to the boy's father:

"Look at the blood sugar value I marked for you. Your son Liang Yu is only 2.4, which is a relatively serious hypoglycemia.

His coma may not be due to epilepsy, but hypoglycemia."

Several family members were shocked and opened their mouths in surprise:

"Ah?! Hypoglycemia??"

"Impossible! His mother has epilepsy, he must have inherited it from his mother!"

"Yes, doctor, there is a local doctor in our hometown who also saw my grandson and said it was epilepsy."

Chen Fang supported his forehead and felt a little headache~