stjorthotic Chapter 388
Chapter 388
Chapter 388
“epilepsy?”
Lin Feng saw the patient’s stiffness, clenched teeth, and coma.
The disease of ‘epilepsy’ emerged subconsciously.
Lin Feng looked at the patient’s boyfriend: “What’s the matter?”
Boyfriend: “Dr. Lin, it’s like this. My girlfriend started like this 2 years ago. From time to time, her whole body convulsed and became stiff, then she lost consciousness, and recovered after 2 minutes… I went to 2 hospitals and said it was epilepsy. My girlfriend doesn’t believe that she is epilepsy, so she is looking for you to have a look…”
It took her boyfriend about 2 minutes, one to five to ten, to tell Lin Feng what he knew.
Very detailed.
Lin Feng nodded.
At this time, the time was almost up, and the patient began to wake up faintly.
Realized what had just happened in “Zero Six Seven”: I had a seizure again.
Lin Feng: “Girl, you want to check, is it epilepsy?”
Chen Yu’s tears fell, and two years of grievances turned into tears.
“Doctor Lin, you must save me…”
Lin Feng comforted: “Don’t worry, I will help you take a look…”
“Xiao Ru, give her a blood sugar test… If the patient faints, we must first rule out the emergency. Low blood sugar can cause dizziness and convulsions, which will pit many doctors who are not paying attention.”
Chen Qingru nodded,
Fingertip blood,
One test,
·Glucose 6.9mmol/L
Confirmed, it is not a convulsion caused by hypoglycemia.
“Have you brought your medical record?”
“Take it.”
The medical record is the examination and diagnosis report of the two hospitals two years ago.
Lin Feng asked while watching.
The previous question was similar to the previous question from the hospital. Chen Yu answered fluently, and Lin Feng couldn’t ask much.
until,
Lin Feng: “Do you have any discomforts like chest tightness or chest pain before you fell to the ground…”
Chen Yu thought for a while: “Sometimes there are, sometimes not, I don’t feel very comfortable in my chest, and my head is a little dizzy…”
Lin Feng nodded.
Then he asked Chen Qingru: “Now, do you know what inspection to do?”
Chen Qingru: “Dr. Lin, you said before, as long as there is discomfort in the chest, in any case, first pull an electrocardiogram…”
Lin Feng is satisfied.
This student is good and learns fast…
Then patiently taught: “The patient felt chest tightness and dizziness before seizures several times. Although we thought she was epilepsy, we still don’t know why she has epilepsy and whether it is the primary disease. We are Shouldn’t it also be routinely ruled out that the cause of the heart causes seizures?”
Lin Feng waved: “You come and make her an electrocardiogram…”
Chen Qingru nodded, and then pulled an electrocardiogram for the patient.
Lin Feng is thinking in his mind that the patient is so young and has no obvious chest pain. It is impossible to be a serious illness such as myocardial infarction.
It may be convulsions (epilepsy) caused by arrhythmia seizures…
It is worth mentioning that Lin Feng has seen two electrocardiograms in the medical records, but he did not see any problems.
After a few minutes,
After the electrocardiogram…
“Doctor Lin, here’s…”
Lin Feng took the ECG, looked at it, and his expression moved.
·The interval between Q and T waves has been extended!
And it’s a significant extension, which can be clearly seen by the naked eye.
Lin Feng pointed to the electrocardiogram and asked Chen Qingru:
“I take a test for you, what does it mean that the QT interval is extended?”
Chen Qingru: “It means that the patient’s heart may have a problem, because the heart discharges, and the heart beats because there is an electrical conduction system in the entire heart. Once the entire heart is electrically charged, the heart will beat once… …Q and T waves are prolonged, indicating that the heartbeat has slowed down…”
Lin Feng nodded: “From this Qt wave, we can think about whether the patient will have sick sinus syndrome, or ventricular tachycardia, etc. These heart problems may cause the patient to have convulsions and loss of consciousness. It’s not epilepsy, but it resembles epilepsy…”
Because of the heart, the heart will not pump blood completely or if it does not pump blood for a short time, the brain will be ischemia and hypoxia, people will lose consciousness, and limbs will twitch 0 ……..
Can explain the patient’s ‘epilepsy’.
At this time, Chen Yu, lying on the bed, heard the conversation between Lin Feng and Chen Qingru, not surprised but delighted.
heart disease?
As long as it is not a serious heart disease,
Better than epilepsy (madman)!
Lin Feng looked at the patient Chen Yu:
“You have a history of’epilepsy’ for 2 years, but you still have recurrent seizures…maybe for a while. There is no way to find out the cause. It is recommended to be hospitalized first. I will arrange a bed for you…”
Chen Yu nodded repeatedly.
“Okay, trouble Dr. Lin…”
“In addition, routine examinations are also to be done, brain CT, blood routines, electroencephalogram, liver and kidney function, blood coagulation indicators, myocardial enzyme spectrum… all have to be checked.”
“No problem, you can check it out, Doctor Lin!”
Chen Yu’s voice was a bit passionate, after all, she saw hope this time.
She didn’t want to see the gaze around herself that looked at herself as if she was a ‘madman’.
After arranging various inspections,
Lin Feng continued to diagnose the next patient,
…
Until the end of the afternoon,
Chen Yu’s inspection results came out only 2.3.
The first is head CT.
·No intracranial tumors…
· EEG, no abnormalities are seen.
Neither check found any problems, Lin Feng didn’t care.
·The items for blood tests are basically out, and no major abnormalities have been found.
·The following follow-up tests: liver and kidney function, coagulation indicators, myocardial enzymes, and troponin are all normal.
All inspections are normal.
Lin Feng: “Make a cardiogram, monitor it 24 hours a day, and see the results… It just happens that I will go to work tomorrow night… When I go to work, it will be enough for 24 hours…”
A cardiogram may be able to determine the possibility of convulsions and seizures caused by arrhythmia.
. .