bookpower Chapter 384
Chapter 384
"Epilepsy?"
Lin Feng looked at the patient's stiffness, clenched teeth, and coma,
Subconsciously, the disease 'epilepsy' emerged.
Lin Feng looked at the patient's boyfriend: "What's going on?" "
Boyfriend: "Dr. Lin, it's like this, my girlfriend started 2 years ago, and from time to time she suddenly did this, her whole body convulsed and stiffened, and then she lost consciousness, and after 2 minutes she recovered... I found 2 hospitals and said it was epilepsy, and my girlfriend didn't believe she was epilepsy, so I came to you to take a look..."
It took about 2 minutes for my boyfriend to tell Lin Feng everything he knew.
Very detailed.
Lin Feng nodded.
At this time, the time was almost up, and the patient began to wake up and turn around.
Realize what just happened: I have a seizure again.
Lin Feng: "Girl, you want to check, is it epilepsy?" "
Chen Yu's tears fell, and 2 years of grievances turned into tears.
"Doctor Lin, you must save me..."
Lin Feng comforted: "Don't worry, I will seriously help you take a look..."
"Xiao Ru, take her blood sugar... The patient faints, the first thing to rule out is an emergency, hypoglycemia can cause dizziness, convulsions, pit many doctors who do not pay attention. "
Chen Qingru nodded,
fingertip blood,
One test,
Blood sugar 6.9mmol/L
Confirmed, not convulsions due to hypoglycemia.
"Did you bring your medical records?"
"Brought it."
The medical records are the examination and diagnosis reports of the two hospitals two years ago.
Lin Feng asked while watching.
The previous question was similar to the previous hospital question, Chen Yu answered like a stream, and Lin Feng couldn't ask anything.
until
Lin Feng: "Did you feel chest tightness, chest pain and other discomfort before you fell to the ground..."
Chen Yu thought for a while: "Sometimes there is, sometimes there is not, the chest is not very comfortable, and the head is a little dizzy..."
Lin Feng nodded.
Then he asked Chen Qingru: "Now, do you know what to check?" "
Chen Qingru: "Dr. Lin, you said earlier, as long as there is discomfort in the chest, no matter what, pull an electrocardiogram first..."
Lin Feng was satisfied.
This student is good and learns fast...
Then patiently taught: "The patient has a feeling of chest tightness before several seizures, as well as dizziness, although we think she is epilepsy, but why there is epilepsy, whether there is a primary disease, we do not know." Do we also routinely rule out the cause of the heart causing seizures? "
Lin Feng waved his hand: "You come to give her an electrocardiogram..."
Chen Qingru nodded, and then pulled an electrocardiogram for the patient.
On Lin Feng's side, he was thinking in his heart that the patient was so young and there was no obvious chest pain, and it could not be a serious disease such as myocardial infarction.
It is possible that convulsions (epilepsy) caused by arrhythmic seizures...
It is worth mentioning that Lin Feng has seen two electrocardiograms in the medical records, and he has not seen any problems.
A few minutes later,
The electrocardiogram is finished...
"Doctor Lin, give..."
Lin Feng took the electrocardiogram, looked at it, and then his expression moved.
· The interval between Q and T waves has been extended!
And it is a significant extension, which can be clearly seen with the naked eye.
Lin Feng pointed to the electrocardiogram and asked Chen Qingru:
"I test you, what does it mean to have an extended QT interval?"
Chen Qingru: "It means that the patient's heart may have problems, because the heart will discharge, and the reason why the heart will beat is because there is an electrical conduction system in the entire heart, and once the whole heart has passed electricity, the heart will beat once... Q and T waves are prolonged, indicating that the heartbeat has become slower..."
Lin Feng nodded: "From this Qt wave, you 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, loss of consciousness, this is not epilepsy, but similar to epilepsy..."
Because the heart is incomplete or does not pump blood for a short time, the brain will be ischemic and hypoxic, and the person will lose consciousness and twitch his limbs.
Can explain the patient's 'epilepsy'.
At this time, Chen Yu, who was lying on the bed, heard the conversation between Lin Feng and Chen Qingru, and was not shocked and rejoiced.
Heart disease?
As long as it is not a serious heart attack,
It's better than epilepsy (madman)!
Lin Feng looked at patient Chen Yu:
"You have a history of 'epilepsy' for 2 years and still have recurrent seizures... It may be for a while, there is no way to find out the reason, 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 should also be done, brain CT, as well as blood routine, EEG, liver and kidney function, coagulation indicators, myocardial enzyme profile... Check it all again. "
"No problem, Dr. Lin, just check!"
Chen Yu's voice was a little excited, after all, she saw hope this time.
She no longer wanted to see the eyes around her that looked at her like a 'madman'.
After scheduling various examinations,
Lin Feng went on to diagnose the next patient,
......
Until the end of the afternoon,
Chen Yu's various inspection results came out.
The first is head CT.
No intracranial tumors, etc...
EEG, no abnormalities seen.
The two inspections did not find any problems, and Lin Feng was not impressed.
The items of blood testing are basically out, and no abnormalities have been found.
Then several subsequent tests: liver and kidney function, coagulation indicators, cardiac enzymes, troponin, are normal.
All the tests, no abnormalities.
Lin Feng: "Let's do a heartbeat, 24-hour monitoring, and see the results... It just so happens that I will go to work tomorrow night... When I go to work, it's enough for 24 hours..."
Cardiac imaging may determine the possibility of convulsions and seizures caused by arrhythmias.
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