"Yes, yes, too, so, my appetite has become very poor."

"Did you have a feeling of 'fever' after you became ill?"

"Well, there really is."

"Have you taken your temperature before?"

"Yes, my temperature is special."

"Oh, what's so special?"

"When I had a cold, I felt a fever and a headache, and when I went to the hospital, the nurse took my temperature, and it was only 36.5 degrees. Later, when the cold was cured, I didn't feel feverish, and my temperature was measured again, and it was only 35.9 degrees. ”

"You're saying that under normal circumstances, your temperature is 36 degrees or below?"

"Yes, it does. Once it was above 36.5 degrees, I was very uncomfortable. I've been in this situation a few times. ”

"Okay, I see. You said that your hands and feet are weak, do you feel less strength than before? ”

"Hmm...... How so? It's said that when you do housework at home, what you can do before can be done now. I just feel very sleepy and get tired easily. ”

"Do you say you have joint pain, do you have pain when you move, or do you have pain when you sit quietly or fall asleep?"

"It hurts when you're active, but it doesn't hurt much when you're sitting still or lying down."

"After the onset of the disease, have you ever given birth to 'pig head and cheeks' (Yingzhou people like to call mumps 'pig head and cheeks')."

"Oh, there really is, and more than once. Sometimes, the left side is born, and the right side comes next, which is very uncomfortable. By the way, I often have ulcers in my mouth. I also went to the dentist and they prescribed me some vitamin B2, but it was very poor. ”

"Do you still have periods?"

"Yes, it's on time."

"Are you menstruating now, is it any different than before?"

When Dean Lin asked, I really felt a little different. I feel that the amount is less, especially before menstruation, and it seems that it is not as moist as before. "At this age, there is no question of being shy or not.

"I'm asking you a very private question that you don't have to answer. Since you became ill, have you been the same as before when you had sex with each other? Lin Lin leaned down and asked softly in the patient's ear.

"It's different, it's completely different, it hurts, it hurts. Now, I don't even dare to touch me for him. The patient was very surprised, this Dean Lin, how to ask every question, is so pertinent.

"Your teeth are fine, right?"

"I've been feeling a little bit of pain lately, but it's okay to bite something."

"Okay, I'll do a check for you." After Lin Lin finished speaking, she did a physical examination for the patient.

This time, Lin Lin asked for a flashlight and tongue depressor from Ding Feng's hand to carefully inspect the patient's oral condition. Lin Lin found that the patient's teeth began to turn black, but the condition was not very serious.

Lin Lin also carefully examined the patient's oral mucosa and found that there were several ulcers, and the oral cavity also appeared relatively dry, which was consistent with what the patient said.

The neurological examination was basically consistent with Ye Xiu's report, the patient's skin appeared dry, mild desquamation, weakened tendon reflexes in the limbs, and no pathological reflexes.

"Okay, thank you for your cooperation, let's go back and discuss, and we will definitely give you a clear answer." Lin Lin's words gave confidence to the patients, but also made the doctors present feel pressure.

"What's the situation? Could it be that Dean Lin already knew the diagnosis of this patient? Zhuo Yiming and Ye Xiu were thinking about it almost at the same time.

Lin Lin washed her hands and returned to the doctor's office to sit down.

"Let's get started, let's start with Dr. Ma's patients, and everyone will express their opinions." Lin Lin immediately asked everyone to start discussing.

Ma Shuiyuan began to speak, but there was nothing new.

"I think the characteristics of this patient's condition are very prominent, which is episodic symptoms."

"In terms of age, the patient is very young and has no underlying diseases of cerebrovascular disease, such as hypertension, diabetes, hyperlipidemia and so on."

"So, I think, the diagnosis of this patient is symptomatic epilepsy. The type of seizure is more likely to be absence seizures or atonic seizures. ”

"Although the current treatment is not effective, can we consider switching to other anti-epileptic drugs?"

"I also agree with Dr. Ma that there are no new additions." Li Yun'e couldn't think of any more possibilities.

"I will continue to maintain the point I had in the last discussion. The patient has episodic symptoms, but her episodic symptoms are mainly weakness. In other words, the patient's brain lesion is a destructive lesion, not an irritating lesion. ”

"So, I think the patient's diagnosis should be TIA, not epilepsy." Zhuo Yiming still did not change his opinion.

"I also agree with Mr. Zhuo's opinion, this patient is the most likely to take TIA. As for the reason, it is difficult to find out at the moment. ”

"Although she does not have an underlying disease of cerebrovascular disease, will there be some other diseases that we have not yet discovered that can cause TIA?" Ding Feng also agreed with Zhuo Yiming's opinion and put forward his own thoughts.

"I also agree with Mr. Zhuo's opinion, although the patient has episodic symptoms, although the patient is very young, but after anti-epileptic treatment, the patient's symptoms have not improved, on the contrary, they continue to worsen."

"So, I'm thinking in a different direction, is the patient TIA? If yes, why? ”

"According to the information on hand so far, it is not possible to give a diagnosis of the cause of the disease I am talking about, so the next step is whether it is necessary to further improve some relevant tests."

"Do you stop the anti-epileptic drugs before you complete the treatment? After all, it has been used for such a long time, and according to the principle of anti-epileptic drugs, this time is enough to see whether the drug is effective. ”

Liu Yulan's speech made Lin Lin's eyes light up. He didn't expect that Liu Yulan had made such great progress.

"Yes, it seems that there has been a lot of discussion about this patient, and the two points of view are clear. Actually, this is a good sign, which shows that everyone has consulted the information and thought deeply. ”

"Let me tell you what I think, this patient has the following characteristics." After Lin Lin praised her, she went straight to the point.

"First, the patient is a woman, and she's very young."

"Second, the patient's symptoms are mainly episodic limb weakness and slurred speech."

"Thirdly, the onset of the disease is not long, and there is a tendency to become more and more frequent."

"Fourth, the patient has been taking birth control pills for contraception, and moreover, taking them for a long time."

"Fifth, the nature of the patient's work dictates that she must remain in a sitting position for a long time."

"Back to the diagnostic aspect of the patient. I think that the patient's clinical manifestations tell us very clearly that all her symptoms are destructive symptoms of the nervous system, not irritating symptoms. On this point, I agree with Mr. Zhuo. ”