She had a great time in this strange and sunny city. But his boyfriend was vaguely worried because she hadn't had epilepsy for almost two months. According to her usual experience, she was about to have epilepsy again.

He spoke simply, giving people a very strong sense of trust. At the same time, he thought that his girlfriend was indeed not very effective in treating her, and she still had several attacks a year, so he agreed to be hospitalized.

Let’s just take a different environment and rest, and I will accompany you. My boyfriend comforted Ms. Lin. Besides, I have checked this hospital and commented online that their neurology department is quite good. Maybe their condition will be more stable after adjustment of treatment.

Of course, Ms. Lin was also worried about her illness, so she agreed to be hospitalized.

After hospitalization, the initial diagnosis was epilepsy.

The doctor arranged for a skull CT, and the intracranial tumors must be ruled out before the next step is treated. These are all lessons. There was a patient who had repeated epilepsy seizures, but the adjustment of the medication was not effective. Later, he did a skull CT and found that the skull occupies the placeholder. The patient was epilepsy caused by a skull tumor. Of course, the drug was not effective. The tumor had to be removed surgically to relieve the condition.

There were no obvious abnormalities in the head CT and no tumors were found.

The doctor gave Ms. Lin another EEG, but no abnormalities were seen. After seeing her EEG report, Ms. Lin wondered why her report was normal. The doctor said that you do not have epilepsy seizures now, and it is possible that the EEG is normal. However, some patients will have abnormal EEG even if there is no obvious epilepsy seizure.

The first battle failed.

No problems were found in both examinations. Ms. Lin was almost used to it.

The blood test project was basically released, and no major abnormalities were found. The director was in rounds and the doctor reported to the director. Liver and kidney function, coagulation indicators, myocardial enzymes, troponin, etc. were all normal.

During the rounds, the director carefully asked Ms. Lin about the illness and asked her if she had any chest tightness, chest pain and other discomfort before she fell to the ground.

Ms. Lin hesitated for a moment and said that she did feel uncomfortable in her chest before falling to the ground several times and her head was a little dizzy.

After listening, the director remained silent and asked the doctor to give the patient an electrocardiogram immediately.

The doctor in the clinic said that the doctor in the electrocardiogram room had already come to do an electrocardiogram, but the report had not been released yet.

The director glanced at him and said that we should pull one of them now, and then let's talk about it first. The patient felt chest tightness and dizziness before several epilepsy seizures. Although we think she has epilepsy, why does epilepsy occur? We don't know whether there is a primary disease. Do we also need to routinely rule out the causes of epilepsy and convulsions caused by the heart? The director's words are not loud, but he is not angry and powerful.

The director was obviously not satisfied with the answer from the bed manager.

The doctor in charge did not dare to speak anymore, so he had to push the ECG machine obediently, pull up the curtain, and pull the patient an electrocardiogram. While pulling, he thought about it. The director was worried that the patient was caused by the epilepsy due to the heart. However, the patient was so young, he did not show any obvious chest pain, and it was impossible to have myocardial infarction, etc. Myocardial enzymes and troponin were also normal.

It is possible that it is convulsions (epilepsy) caused by arrhythmia attacks, but the patient has done an electrocardiogram many times in the hospital, and they all said that no obvious problem was found. The patient's boyfriend told us about this. So it is unlikely that it is a problem of arrhythmia. But since the director has given the order, he still has to do it. After all, the director has his own considerations.

After a few minutes, the electrocardiogram was finished and the result was also revealed.

The director took the electrocardiogram and read it carefully. Although he is the director of neurology, the director of this age has a clear understanding of the entire internal medicine knowledge, so reading the electrocardiogram is naturally no problem.

The director's brow suddenly frowned.

This tiny detail was captured by the clinician. Is there really a problem? He thought to himself.

Look, the director's tone was very slow, and he told the doctors around him that the patient's electrocardiogram was still problematic. You see if the qt interval has been extended? Although I have not measured it with a ruler, it seems that the qt interval has been extended with my naked eyes.

Everyone was in an uproar.

The extension of the qt interval is a big problem, which means that the patient's heart may have problems. The heart will also be discharged. The reason why the heart beats is because there is an electrical conduction system in the entire heart. Once the entire heart is electrostatic, the heart will beat once. When the electrocardiogram sees the extension of the qt interval, it may mean that there is a problem with the heart.

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For example, will the patient have pathological sinoatrial syndrome, or ventricular tachycardia, etc. The director said that these heart problems may cause convulsions, loss of consciousness, and similar to epilepsy. Because of the heart, the heart may insufficiency or short-term failure to pump blood, the brain will be ischemia and hypoxia, people will lose consciousness, and convulse the limbs. This can be explained.

The director's words made the doctor sweat profusely.

Although we are neurologists, we also need to understand some diseases in other departments. When a patient comes to our neurology department, it does not mean that he is a disease in the neurology department. Before the diagnosis is confirmed, no one knows which department the patient will have. The director said meaningfully.

However, after taking antiepileptic drugs, the epilepsy has indeed been relieved a lot. It used to occur once every few days, but now it only occurs once every few months. How can this be explained? A doctor raised a question. If it is caused by the heart and epilepsy, then the medication should be ineffective.

The patient has not completely controlled epilepsy. The director said that it is hard to say why now, but we must be suspicious. I have seen a patient with repeated epilepsy for more than ten years. Every time the diuretic needle is applied, it can control epilepsy, but it cannot be completely cured. Later, I learned that the patient is epilepsy caused by hypoglycemia. Every time the diuretic needle is effective because the nurse uses glucose and diuretic needle to relieve hypoglycemia, which controls epilepsy. The patient is not really epilepsy. Later, after another investigation, it turned out that the patient had insulinoma, and the tumor intermittently secreted excessive insulin. Insulin will cause hypoglycemia, which induces convulsions. Misdiagnosis of epilepsy for more than ten years is also pitiful and sad.

The director's example is indeed thought-provoking.
Chapter completed!