"Since it is a devastating symptom, the patient should not be epilepsy, but a neurological loss of nerve function at the ischemic site caused by a seizure, transient ischemia of the brain."

"The patient has no history of hypertension and no underlying cerebrovascular disease such as diabetes. So, in terms of finding the cause, I hope to find a cause and then use monism to explain all the signs and symptoms of this patient, and even explain her test results. ”

"The patient is young, with a sudden onset and frequent seizures. So, I zeroed in on the cause as cardiogenic. ”

"Combined with the patient's medical history and the prolonged use of birth control pills, I believe that the patient is likely to have a relatively overlooked, but very common heart disease: patent foramen ovale."

"The symptoms of this patient are most likely from small emboli in the lower limbs or pelvis, which enter the brain through the patent foramen ovale, causing an ischemic attack in the brain."

"The formation of these emboli is directly related to the patient's long-term use of contraceptives, and indirectly related to the nature of the patient's work. If these two conditions are not changed, the patient's condition is difficult to control. ”

"Therefore, the next step is to improve the examination of cardiac ultrasound, of course, this ultrasound examination, when we prescribe the examination list, we must write the direction of our diagnosis clearly, so that the doctor in the B ultrasound room can carry out relevant examinations in a targeted manner. After all, some small, patent foramen ovale is not easy to detect if you don't pay attention. ”

"If the patient's condition allows, it is best to do another MRI of the head to see if there are any new changes, such as the formation of hypointense areas of the brain."

"As for treatment, anticoagulation can be given first. Secondly, the relationship must be made clear to the patient and asked her to stop taking the pill immediately. ”

"If the results of the follow-up examination come out, if it is really patent foramen ovale, you can ask for the patient's opinion and then decide whether to perform surgical treatment."

When Lin Lin was analyzing, the entire office was very quiet, and pins could be heard.

Everyone present, including Zhuo Yiming, didn't expect that Lin Lin's thinking would jump so much, tracing the cause of the disease to the heart and to the patent foramen ovale.

It's a disease that everyone knows, but no one has ever thought about. When Lin Lin said it, Zhuo Yiming nodded frequently.

"Let's see, if you have any comments or good suggestions." Lin Lin asked.

"Dean Lin's thinking is beyond our reach. I think Dean Lin's analysis is very reasonable, and I agree with it. Zhuo Yiming said.

Seeing that no one said anything more, Lin Lin turned her attention to another patient.

"Doctor Ye, you come, your patient, you speak first." Lin Lin named Ye Xiu's name.

"This is a female patient with a subacute onset and progressive sexual progression. Her main symptoms were numbness and weakness in her limbs. ”

"From the neurological examination, the skin of the patient's limbs is relatively dry and has mild desquamation, which is consistent with changes in peripheral nerve damage."

"In addition, the patient's muscles are slightly relaxed, the symmetry of tendon reflexes is lost, the pathological signs are negative, and it is also attached to the manifestations of peripheral nerve injury."

Therefore, the diagnosis of this patient is multiple peripheral nerve injury. Qualitative diagnosis, I consider multiple peripheral neuropathy. ”

"In terms of treatment, although it is the damage of peripheral nerves, although most of the peripheral nerve damage can be recovered with appropriate treatment, it also takes time. Therefore, I believe that the patient should still maintain the original treatment regimen. "Ye Xiu's analysis, logically, has no problem.

"Well, well analyzed. Do you have no questions about this patient? ”

"Yes, at the beginning, I only had one question, which was the patient's joint pain, which I couldn't explain clearly. Just now, when Dean Lin asked about his medical history, the patient said that he had a fever. According to the patient, her body temperature during her hospitalization was indeed a low-grade fever. This is a new question, and I can't explain it. ”

"Okay, Dr. Ye is good." Lin Lin appreciated Ye Xiu's performance very much.

"Doctor Ye must be good, she is your junior sister." Ding Feng interjected.

"Oh, is it? How did I not know? Lin Lin was very surprised.

"It was arranged by the personnel department, I don't know, I thought you knew."

"It's no surprise that I'm not in charge of the HR department. Looking back, I have to thank the HR department for recruiting a good seedling for our neurology department. Well, go ahead. ”

"I agree with Dr. Ye that this patient must have peripheral nerve damage, and as for the qualitative diagnosis, it is indeed not easy." Liu Yulan was obviously unprepared for this patient.

"I agree with Dr. Yip's view on this patient's positional diagnosis. In terms of qualitative diagnosis, I was thinking that when Dean Lin asked about her medical history just now, the patient said that her stomach was very poor. If so, will it be a disease caused by B12 deficiency, as was the case with a patient with vitamin B12 deficiency diagnosed by Dr. Lin before? Li Yun'e remembers the patient vividly.

"When I was doing my rounds, I considered the same diagnosis as Dr. Yip's analysis. However, what Dr. Li said just now is very reasonable, and Dean Lin's questioning of the medical history may be the cause of this patient. Zhuo Yiming also agreed with Li Yun'e's opinion.

"I have no new opinions, and I agree with Mr. Zhuo and Mr. Li." Ding Feng had a hunch that this patient was definitely not this diagnosis. However, with the depth and breadth of her knowledge, it is indeed impossible to conduct an in-depth analysis.

"Although the diagnosis of this patient is clear, it will be a great gain for everyone." As soon as Lin Lin opened her mouth, she said that the patient's diagnosis was very clear, which immediately attracted everyone's attention.

"Let me tell you what are the characteristics of this patient." Lin Lin continued.

"First, this is a 45-year-old middle-aged woman with insidious onset, progressive sexual development, and the main complaint is numbness and weakness in the limbs."

"Second, after the onset of the disease, the main problems of the patient are fever, poor appetite, and dry mouth. Note that the dry mouth of this patient is very noticeable. ”

"Imagine a person who is very fond of bubble cakes, and now he is scared when he sees them. This is because there is little or no saliva production and it is not possible to eat, which is very abnormal. ”

"Thirdly, the patient has a particular manifestation, which is frequent episodes of mumps, and it is present on both sides. This point, we must pay attention to, is helpful in the diagnosis of this disease. ”

"Fourth, the patient's joint pain is characterized by pain when moving, and pain decreases or disappears when at rest."