(Thanks to my friend U18 and Food Safety World Monthly Pass for encouragement)

The child didn't sleep very long, and he woke up before the results of the blood test came out.

Maybe it's because I've experienced this kind of thing many times, so I don't care much about this situation, and I just rubbed my face very simply.

"Brother Hui, research and research. Narcolepsy, as well as specific hypertension, did not work after changing a variety of antihypertensive drugs. Liu Banxia walked into Xu Hui's consultation room.

"It's a bit difficult to do, although some patients also pick medicine, but it can't all work. Xu Hui said.

"I'm only 16 years old, and although I'm a little fat, I'm not outrageously fat. High pressure 190, a little evil. Liu Banxia said.

"Caused by narcolepsy?" asked Xu Hui.

"It should be about the same, the child's father said that he had narcolepsy first, and then high blood pressure. Just now we were learning about the condition, and the child said to sleep and slept. Liu Banxia said.

"I have also seen all the CT scans done in other hospitals, and I have found no brain problems. And the child does not feel any other discomfort, just sleeping. ”

Xu Hui grinned, "Then I can't think of anything." Narcolepsy is so annoying, if it doesn't work, you can find someone else to take a look. It's not easy for you, you just came back to work, and today these two patients are good enough. ”

"Hey...... , I hope to have a peaceful day. Liu Banxia said with a wry smile.

He can still work other diseases, but this patient, whether it is high blood pressure or narcolepsy, is not so easy to deal with.

"Dr. Liu, the blood test results are out, and the kidney function has been slightly impaired. While discussing with Xu Hui, Liang Xiaolin walked in.

"If your blood pressure is so high, it will definitely have some ripples. Liu Banxia said and took the inspection report.

At the beginning, he was worried that high blood pressure might have a big impact on the child's body, and now it has come true. After reading it, my mind is somewhat wider, although the indicators are a little high, but the impact is not very large.

As long as the blood pressure can be controlled, the kidneys will basically be able to repair themselves. But for this patient, this high blood pressure is too strange.

"Dr. Liu, what should I do next?" asked Liang Xiaolin.

"Hey...... , it's not easy to do, and there is no way to do it except continue to change other blood pressure medications. I don't even want to do the instrument check, and the results should be the same as before. Liu Banxia said.

"At first, I thought it might be that the lesion was relatively small and didn't scan it out. But their films have accumulated so much, if there were lesions, they would have worsened long ago. ”

"Then what should I do, just give up?" Liang Xiaolin frowned.

"I think about it again, I can't cure narcolepsy, and see if I can find a new way to treat high blood pressure. Liu Banxia said.

Today's patient is the first time in his long history of medicine that he has a feeling of nowhere to start, even if there are patients who can't be rescued before, but he also knows what the problem is.

"Do you usually feel anything else when you sleep, for example, except for suddenly falling asleep sleepily. Do you feel dizzy or uncomfortable after waking up?" asked Liu Banxia, who walked outside.

The child shook his head, "No matter how long you sleep during the day, you can still sleep at night if you want to." Well...... , even if you don't want to sleep, maybe it's a habit of the biological clock, right? I can sleep, too. ”

"What about your usual diet?" Liu Banxia asked again.

"I'm all about less oil and salt now, and eating more vegetables and fruits. I am also afraid that my blood pressure is too high, and then my blood pressure is quite high every day. The child said.

"It's narcolepsy, right? Dad, let's not bother with this. It's been so long since you've been out? My mom will have to call and ask later. ”

"Doctor, how else do you have to check it?" the child's father looked at Liu Banxia.

"Judging by the results of the blood test just now? Because high blood pressure has already caused some damage to his kidneys. So let's focus on narcolepsy next? High blood pressure is also a concern. Liu Banxia said.

"It's not so easy to diagnose, and there are many causes of high blood pressure. Is it also possible that high blood pressure is caused by narcolepsy? These are also not so easy to diagnose at the moment. ”

"I was hesitant to do an instrument check. Combined with the current situation, it is better to make one. Although it may be the same as the previous examination? But I don't feel at ease if I don't do it. ”

"Do, do, I'll go pay the money, you can make a bill." The patient's father said.

With such a cooperative family member, Liu Banxia has a sense of powerlessness.

Now he is hopeful? This hope may come from Huang Haibing's boasting about himself. But what about the inspection after a while? There is as much hope as there is as much disappointment as there is.

Is your child visibly resistant to such an examination? But I didn't say anything when I saw my father being so positive.

"Hey...... Is there really no other way?" asked Liu Haibing.

Liu Banxia shook his head helplessly, what was he just about to say, after his eyes fell on the father and son who went to do CT with volunteers? But he froze.

didn't care about Liu Haibing, and chased after him directly.

"Doctor, is there anything else?" asked the child's father.

"Wait a minute, kid, and go on your own. Liu Banxia said.

The child glanced at him and walked a little further.

Liu Banxia was overjoyed, "Don't you think he feels a little weird when he walks?"

"Doctor, is it strange?" said the child's father with a wry smile.

"Since he got this disease, the child has not been happy for a day. He is almost so listless when he walks, what else can we say? ”

"No, no, it's not listlessness, it's ataxia, there's definitely something wrong with the head. Liang Xiaolin, who was following on the side, shouted loudly and was a little excited.

Liu Banxia smiled and nodded, "One of the manifestations of ataxia is faltering, you can notice that the heel of his right foot is obviously worn a little more than that of his left foot. ”

"If you just walk listlessly, the human body will not be so bad if there is a deviation in the wear and tear of the feet under the adjustment of self-balance. ”

"Ataxia is often a sign of a lesion in the cerebellum, which means that your son's narcolepsy may have been misdiagnosed. Let's stop doing CT, I'll change it now, let's do an MRI of the head and neck. ”

"Doctor, is it really? really not narcolepsy?" the child's father grabbed Liu Banxia's arm.

"The probability is very high, because now the child's performance is more consistent with cerebellar tonsillar herniation malformation, and the explanation of this disease is also a bit complicated, so let's do an examination first." Liu Banxia smiled and nodded.

"The reason why it will be missed is also related to the child's symptoms. One of the symptoms of this disease is a headache, but the child does not. Then it may be that the child's tolerance is stronger, or because of the influence of this disease, the child's blood pressure rises, but the analgesic effect is achieved. ”

"Dr. Liang, use my authority to change the list. When we get the MRI side, we also talk about our inferences in advance, so that they can see it more carefully. ”

Liang Xiaolin nodded happily and ran to the computer to operate.

Now let alone the child's father, even the expression on the child's face is a little richer.

"Mr. Liu, how did you think of it?" Xu Hui, who heard the movement, also ran out.

"I'm not sure at the moment, it's just speculation. Liu Banxia said.

"We all ignore one point, his sudden sleepiness is more serious, but we take it for granted that it is caused by narcolepsy. ”

"There is another condition that I saw, but I did not describe. That is, the child has intermittent snoring while sleeping, which I ignored. ”

"Sudden sleepiness, snoring, this is already a little different from narcolepsy, some of the central sleep apnea syndrome. Coupled with the fact that he showed ataxia, I think it may be caused by cerebellar tonsillar herniation malformation. ”

"Coming back again, the main manifestation of this disease is pain, usually in the occipital, neck and arms, which is the kind of burning radiating pain. ”

"There is no child on the body, which is a special case. It did not cause anything else, but caused central sleep apnea syndrome and sudden sleepiness. ”

"Only neurological reasons can have such an immediate effect, right? Anyway, now that his various symptoms are entangled, it is very confusing. ”

"When we do CT scans, we all scan the brain, who would scan the cervical spine in particular? I have never heard of narcolepsy on the cervical spine. ”

Xu Hui nodded, "That's pretty much it, I think it's pretty much the same after listening to you, otherwise I don't know how to explain." Although it may seem outrageous, it fits well with this patient's situation. ”

"But it's amazing, the manifestations of the disease are really diverse. The ones summarized in our medical books are just common symptoms. ”

This compliment is real, and Liu Banxia's performance today is definitely amazing. If it is really diagnosed, it will leave a heavy mark in the second hospital, and it can be recorded as a classic case.

Then the big guy stayed at the computer, waiting for the MRI scan results.

Ding! Strange High Blood Pressure Mission Complete

Gain 500 XP, 500 Diagnostics Skill Mastery, and 5 Glory

This mission is rated as Perfect, gaining 500 XP points, 800 diagnostic skill proficiency points, and 10 glory points

Congratulations on raising the host level to level 43, 93435/98580. Gain 1 stat point and 5 glory points

Looking at the scan results, it can already be diagnosed, but Liu Banxia didn't expect to give such a generous reward.

In addition to being happy, I am also a little worried, just with the skill proficiency of diagnostics, I still have so many surgical skills to master.

Dressing change and suture surgery, such basic skill proficiency is what I am most lacking at present.