Chapter 23 - Clinical Case: Temporal Lobe Epilepsy

Chapter 23: Clinical Case: Temporal Lobe EpilepsyGastrointestinal surgery.

Dr. Tan Feng, the chief surgeon, has been hearing a lot about an impressive intern in the emergency department lately, performing surgeries like a seasoned chef, with a touch of artistry.

Today, he’s conducting his usual department rounds.

And then…

“Have you heard? Dr. Lin did another surgery, colon cancer, the kind that involves resection…”

“What? Completed in just one hour?”

“Really?” Sᴇaʀᴄh the ɴovᴇlꜰirᴇ.nᴇt website on Gøøglᴇ to access chapters of nøvels early and in the highest quality.

“So fast? Faster than our chief?”

“Shh… the chief is right behind us… Chief is amazing!”

Feeling the attending physician’s disrespectful expressions, Tan Feng snorts dismissively and leaves.

…

“Achoo~~~”

In the emergency department, Lin Feng sneezed. He didn’t think much of it. He continued to educate patients and their families on postoperative care for colon cancer surgery, as there shouldn’t be any major issues after a successful operation.

In the following days: the patients stay in the hospital for observation, nurses maintain fluid and electrolyte balance, provide parenteral nutrition therapy as needed, change the dressing of the abdominal incision on the third day, and perform timely drainage if there were any problems.

On the first, third, and fifth days, blood tests and electrolyte checks were done to adjust antibiotic medications and parenteral nutrition therapy based on the results.

After giving instructions, Lin Feng continued with his consultations. Soon, a young man in his twenties with an extremely pale face, even paler than any patient Lin Feng had ever seen, walks in, clutching his stomach.

This patient looked like he was on the verge of collapse, more like a case of a heart attack or aortic dissection.

Lin Feng quickly inquired about his condition. The patient, in pain, smiled and said, “Doctor, don’t worry, I’m used to it. It started six years ago after I had a drink. I’ve experienced this pain hundreds of times since then.”

Lin Feng: “…………”

While surprised, he felt relieved.

“Let me see your medical records…”

They must be quite extensive. As expected, the patient handed over three thick medical records to Lin Feng, filled with examination reports, and diagnostic forms…

Ruled out pancreatitis…Exclude stones…Exclude myocardial infarction……

They’ve ruled out many diseases. But they just couldn’t find the cause.

These three medical records represent visits to almost all of the top-tier hospitals in the province, and still, they couldn’t identify the cause.

The patient says, “Doctor, just give me painkillers. After all, you won’t find the cause anyway.”

Lin Feng nods.

First, administer analgesics for pain relief, then continue investigating the underlying cause.

I had tried them all.

The results had been inconclusive, and the effectiveness of these medications had been minimal. This is quite perplexing.

Suddenly, Lin Feng had a moment of enlightenment in his mind.

“Epilepsy?”

Lin Feng recently browsed through a doctor’s public account where they mentioned a case with symptoms similar to this patient.

“Let’s try diazepam…”

Diazepam, or Valium, is a medication/injection used with other antiepileptic drugs to treat major or minor seizures.

The nurse quickly administers the diazepam injection intravenously. Soon after, the patient felt a significant reduction in pain.

The patient is surprised, “Oh… it’s effective, doctor. What medication is this?”

Lin Feng says, “It’s a diazepam injection. If you experience pain in the future, you can ask the doctor to try this medication.”

The patient nods repeatedly, “Diazepam injection, right? Okay, I’ll remember that.”

“Go and have these two tests done…”

The patient rushes back to the emergency department with the test reports.

“Doctor, please take a look. Did you find anything?”

Lin Feng reviews the test reports:

MRI result: “Magnetic resonance imaging. Left temporal lobe cystic lesion with solid wall nodule.”EEG: “Characteristic of temporal lobe epilepsy.”

Lin Feng hands back the reports.

Lin Feng says, “It’s been identified. It says here, temporal lobe epilepsy, which is causing your pain.”

Patient: “Temporal lobe epilepsy?… Doctor, how can this be treated?”

Lin Feng replies, “For specific treatment, you should consult a specialist in the Department of Neurology.”

This was a form of intractable epilepsy that could not be treated with medication alone. Lin Feng didn’t have a good solution either, so they didn’t tell the patient how to treat it. The Department of Neurology had more experience in this area, and it’s a good opportunity for them to shine, isn’t it?

(Neurologist: I %…@#$%@… I’m really grateful to you!)