"Why this patient's triggers are fixed every time, and it is related to sun exposure. To be honest, I can't answer that question either. ”

"I remember seeing a report in the journal Foreign Medicine about a patient with epilepsy in a country where he ate with his hands."

"It's very strange that this patient only has a seizure when he does the gesture of grasping rice with his hands. Other times, he never had seizures. ”

Later, the patient wore a Holter EEG device and then induced the seizures through the gesture of grasping rice. At the same time, the EEG recorded typical sharp and slow sharp waves. ”

Finally, the authors refer to this seizure as a pilaf-induced seizure. As for the reason, it is not clearly written in the report. ”

"As far as I know, there have been no reports of sun-related seizures in the world. I suggest that Dr. Dong write it as a paper. Of course, you will not write until the information is complete. ”

"Don't underestimate the reports of these cases. Sometimes, the report of a single case can lead to a particular disease. The most typical case is Parkinson's disease. ”

"Probably in 1887, a British doctor named Parkinson's wrote about three patients. All three patients had several characteristics in common. Increased muscle tone and bradykinesia. ”

"Later, patients with such characteristics were reported one after another, and the symptom characteristics of such patients were supplemented more perfectly, and later generations named this disease Parkinson's disease."

Lin Lin told the story, and everyone was fascinated by it.

"How can this guy fit so many things in his head?" Ling Xiaoyun continued to be surprised.

"Dean Lin is so good, and his knowledge is too extensive." Ye Xiu felt more and more that it seemed out of reach to catch up with Lin Lin.

"Great, such a story is so helpful for me to write an article. This Dean Lin is really amazing. Chen Zhengtong thought to himself.

"Mr. Li's second question is why the patient maintains a seizure form for a long time. In fact, this situation exists in many epilepsy patients. ”

"If the lesion is in or near the precentral gyrus of the cerebral hemisphere, perhaps, the patient's seizures will be diverse. However, the form of seizures in this patient is indeed a bit special. ”

"When he had a seizure, he was in a state of hazy consciousness, and he was sweating a lot and eating a lot. In such seizures, the focus of epilepsy is usually in the limbic lobe. This area is not prone to multiple forms of seizures. ”

"Of course, it cannot be ruled out that abnormal discharges are transmitted to the contralateral cerebral hemisphere through the corpus callosum, thus causing changes in the type of seizures."

"However, we have not found this in this patient. Whether there will be one in the future, I'm not sure. However, if we can treat it in time, the chances of this happening in the future are unlikely. ”

"Regarding the EEG examination, I have to say that this is a pain point in the neuroelectrophysiology room of our hospital. We are known as the leader of neurology in Yingzhou, but we do not have a dynamic electroencephalogram examination instrument, which is unreasonable. ”

"Please Director Ding make a plan, type the application report, and buy this instrument back. At the same time, relevant personnel will be sent out for training. ”

"Holter is important to us, but it's not a panacea. Dr. Ma, tell me about the diagnosis of epilepsy, what is the diagnostic criterion? Lin Lin suddenly asked, which is also the characteristic of Lin Lin's ward rounds.

"Clinical manifestations plus ancillary examinations, of which, among the auxiliary examinations, electroencephalogram is the most important." Ma Shuiyuan's answer is a bit of a big encirclement.

"What do you think about the EEG examination?"

"Electroencephalogram examination is an indispensable method and means in the diagnosis of epilepsy, especially the ambulatory electroencephalogram that Dean Lin just mentioned." Ma Shuiyuan's answer still didn't get to the point. Obviously, Ma Shuiyuan has not yet fully read the chapter on epilepsy.

"I won't name names, everyone can talk about this."

"Let me tell you about it." Ye Xiu spoke. Lin Lin is very optimistic about Ye Xiu's professional understanding.

"The positive rate of EEG is only 60 to 80 percent of all epilepsy patients. In other words, 20 to 40 percent of people with epilepsy have negative EEG tests, including ambulatory EEG tests. ”

"Therefore, the most important thing in the diagnosis of epilepsy is the exact medical history, the history described by the person who witnessed the whole process of the patient's seizures. Just like today's patient, the seizure described by his wife has the ultimate diagnostic value. ”

"For episodic disorders, a history is very important. I remember that Dean Lin once diagnosed a patient with patent foramen ovale, and at that time, the two schools of thought in the department were very hotly debated. ”

Eventually, Dean Lin came back for rounds and inquired in detail about the seizures, and determined that the patient's seizures were caused by destructive lesions in the brain, not irritating lesions. Of course, the final result confirmed that Dean Lin's analysis was correct. I was very impressed with this patient. ”

"Well, Dean Ye has read the chapter on epilepsy very thoroughly."

"Ladies and gentlemen, medicine is a discipline that cannot be understood half-understood, and medicine is a bottomless discipline. Therefore, all of you here, from the moment you step into the door of medicine, learning will accompany you for the rest of your life. Moreover, this kind of study must be in-depth study, and it cannot be superficial. ”

"Let me answer Mr. Li's last question, that is, why don't you consider that this patient's seizure is caused by hypoglycemia."

"As you know, a normal person's blood sugar is the lowest in the morning fasting blood sugar in 24 hours a day. However, this patient has never had a seizure at this time. ”

On the contrary, his seizures came when he finished breakfast and went to work in the fields. This is not the time when the patient's blood sugar is at its lowest. ”

"Of course, there are exceptions to everything, and each person's individual differences are great. Therefore, this question raised by Mr. Li can be reflected in the next examination to see if it is really related to blood sugar. ”

"We can't let go of any of the more likely causes, the complexity of the disease, that compels us to do so. I believe that in this world, no doctor dares to say that he is omnipotent, and can diagnose and treat any disease. ”