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Vol 4 Chapter 810: Tourette syndrome

  Neurosurgery ward.

Today is Monday, and it’s the neurology department’s turn for the dean’s ward rounds.

 Chen Qi was wearing a white coat and holding a small hammer in his hand. He was tapping the palm of his hand with one hammer after another. Under the leadership of Director Xia himself, he went through the wards one by one.

The dean's ward rounds are very formal. The dean walks in the middle, surrounded by a large group of white coats beside and behind him.

Following the dean are the directors of the medical department and the hospital office, followed by the directors and deputy directors of the clinical departments, followed by doctors above the senior and deputy senior positions, doctors at the attending level, ordinary resident doctors, and finally, training doctors and intern doctors.

 It is very normal for 2 to 30 doctors to go out during a ward round.

 At this time, you can often see the ecological chain of the hospital. Whoever is closest to the president is often the person with the highest status in the hospital.

Of course there are exceptions. There are always some doctors who want to show off in front of the dean, so they will try their best to get close to the dean.

Some people want to make progress, and there are also many Buddhist doctors. These doctors often walk at the back when the dean does rounds on the ward. Sometimes the ward is crowded, and they would rather stand outside the door to get some fresh air.

Of course, it is also possible that these doctors are afraid of being asked questions. If they cannot answer the questions, they will die on the spot, which will also leave a bad impression on the dean.

General deans like to ask some questions during ward rounds in order to show their authority, and they often like to ask questions of doctors who are active.

With this question and answer, the process is simple and the scene looks very harmonious.

But as the second general dean, Chen Qi especially likes to "embarrass" those Buddhist doctors.

 Aren't you afraid of being asked questions by the dean? Aren't you hiding behind on purpose? The more you fear, the more I will give you, and I won’t scare you to death!

Chen Qi just finished a physical examination on a patient and looked around.

The smarter doctor knew that the dean was about to ask a question and quickly puffed out his chest. Chen Qi rolled his eyes at these flatterers silently, and then looked towards the end:

 “Come, the little girl with the eyes and the ponytail, come here, come here.”

This little doctor was almost crying, thinking that I had already hid outside the door, why did he come to call me?

But the dean had called for people, and it would be impossible not to go, so he came to the bedside with a smile that was uglier than crying, and quickly nodded and bowed:

“Hello, Dean, I am an intern at Haidong Medical University, and my name is Ye Fen’e.”

 Chen Qi smiled and nodded, and said in a very 6+1 manner:

“Attention, Mr. Ye, I’m going to give you a question. Since you are a student, let me give you a basic question. What is a stroke?”

This female student was so nervous that she trembled when she spoke:

“Explain, the fundamental cause of hemorrhagic stroke is intracerebral hemorrhage, such as hypertensive cerebral hemorrhage, subarachnoid hemorrhage, etc. What common people call stroke is cerebral stroke.”

 The more nervous you are, the more Chen Qi wants to tease her, deliberately pretending to be serious:

 “Well, just one hemorrhagic stroke?”

“Oh, there is also ischemic stroke, which is a typical example of cerebral infarction.”

 “Then what are the signs of stroke?”

"There are too many of these, including recurring severe headaches at a fixed location that last for a long time and may be accompanied by vomiting; sudden and persistent unilateral eyelid drooping and double vision; recurring inflexibility and weakness in limb movements. , unclear speech; recurring dizziness, rotating vision; recurring transient blackening of one eye, etc."

 “What is arteriosclerosis?”

"Arteriosclerosis refers to the deposition of lipids on the arterial wall. It not only forms large and small plaques on the arterial wall, causing stenosis or even occlusion of the arterial lumen; it can also damage the normal structure and elasticity of the arterial wall, leading to Blood vessels rupture and bleed.”

 “What is cerebral artery stenosis?”

The more Chen Qi asked, the more he became addicted. The dean couldn't even defeat a student by asking questions. Doesn't that make the dean incompetent? So each question becomes more difficult than the last.

The female students were almost crying: "House, Dean, you can't just keep asking me alone. You can also ask others."

 Hahaha~~~ Many doctors in the ward chuckled.

 Chen Qi stopped teasing her and said with a smile:

"Don't be nervous. You answered very well. Why are you hiding behind me? Am I so scary as the dean? My little classmate, please follow the handsome guy closely."

Hehehe~~~The laughter became one again.

This female classmate smiled on her face, but she was scolding her in her heart: Do you think you are funny and handsome?

 Dean Chen, who thought he was very approachable, walked into a new ward with the support of a group of flatterers.

As soon as Chen Qi entered, before Chen Qi could say a few words of humor, the little boy on the hospital bed threw the bottle on the table to the ground and cursed:

 “Stupid pigs, a group of fools, fools.”

As he spoke, the little boy twitched a few times, and then quickly hid in the arms of his parents, burying his head and refusing to come out.

 Chen Qi was a little stunned, wondering whose unlucky child was so ungrateful, but it was impossible for him as an adult to argue with a child.

 “What’s going on with this child?”

 The attending doctor quickly squeezed out of the crowd, holding the medical record in his hand, and began to report the condition.

 As the doctor narrated, such a child came to everyone’s mind:

 Children with the disease will make involuntary movements, such as twitching, blinking, pouting, grimacing, facial distortion, shrugging shoulders, shaking their heads, saying vulgar, obscene or curse words, breaking things suddenly, and even beating classmates suddenly.

 Chen Qi had an idea in his mind.

Just like focusing on keywords during an exam, these keywords can actually rule out many diseases, thus further narrowing the scope of diagnosis.

 Chen Qi already had two answers in his mind, but he was not sure which one it was.

The attending doctor continued to introduce: "The child had been treated in seven hospitals, and after being ruled out for mental illness, he came to our hospital for treatment. The report was completed."

Every doctor present was running through possible diagnoses in their minds.

Director Xia introduced at this time:

“After admission, we first completed various examinations, but both the electroencephalogram and brain CT showed that they were normal. We treated him according to epilepsy, and it seems that the effect is not significant at present.”

 The child’s father Zhong Hengyuan also introduced:

“Hello, Director Chen, since my son became ill, we have taken him to the provincial capital and Shanghai for medical treatment. The most common diagnoses made by those doctors are tics, and some doctors think it is mental illness, but in the end no cause can be found.”

Director Xia answered:

“At present, mental illness and epilepsy can be ruled out. If it is just a common tic disorder, epilepsy drugs are also suitable. However, if all drugs are used, the child will continue to have convulsions and other symptoms.”

  Chen Qi had the answer in his mind, and of course he wanted to remind his colleagues, so he asked:

"It's not just a guess, haven't you noticed? Since we came in, this child has made all kinds of ugly gestures and twitches. He has also cursed people from time to time, and even knocked down the table and quilt."

 Everyone started to think about it and observed more carefully the little boy's "sickness" from time to time.

Chen Qi looked at the children's parents again, "About how old was your son when he started to have this condition? What is he like at home and what is he like at school?"

Zhong Hengyuan has answered the doctor countless times, so he blurted out:

“It was around the first grade of elementary school. At first, I was often complained by classmates, saying that my son bullied his classmates. Later, it progressed to the point where he would suddenly stand up and talk loudly or throw away books when he was in class.

 Later on, I would have cramps from time to time, and it would be like this. "

 Xiao Minghao happened to start twitching a few more times at this time, and Chen Qi noticed that the child's consciousness was awake.

Zhong Hengyuan is still complaining:

“Many teachers and classmates thought that the child was naughty, so they isolated my son very much, and some teachers even wanted to punish him corporally. Later, my relatives and neighbors also thought that this made my Xiaohao an unpopular person and was disliked by others.

  But our husband and wife firmly believe that my son is not a poor student, but has a disease, and he will be fine as long as the disease is cured. Dean Chen, you are a famous miracle doctor in Vietnam, better than foreign doctors. Please save my child. "



 Chen Qi was very sad to hear this, and at the same time he felt lucky for this child.

If he hadn't encountered such a considerate and courteous parent, he would have firmly believed that his son was sick.

But if other parents abuse and beat their children at all times because the teacher complains, and do not take the initiative to seek medical treatment, the consequences can be imagined, and the child's condition will only get worse.

If this parent insists that the child is mentally ill and treats him as a fool, the child will be ruined for life.

So Chen Qi looked at his parents and comforted him:

“Don’t worry, our Yue Traditional Chinese Medicine Hospital will always be able to come up with a solution. We must first figure out what kind of disease it is and whether it can be treated.”

 While everyone was comforting the family members, Xiao Minghao whispered:

 “Doctor, I want to go to school…”

 Chen Qi also has a pair of 8-year-old twins at home, so when he saw the 10-year-old Xiao Minghao looking scared and helpless, he felt compassion in his heart:

“Your name is Zhong Minghao, right?”

 “Yes, uncle.”

“You just said you wanted to go to school, right?” “Yes, uncle, I want to go to school and play with my classmates, but they don’t welcome me and always call me a bad boy.”

Chen Qi squatted down and asked: "So Xiaohao, do you tell me you are a bad boy? Did you deliberately make trouble in class and beat your classmates?"

Children Zhong Minghao’s eyes were full of tears:

“I’m not a bad boy, I just can’t control myself, and I don’t know why I always curse and hit people unconsciously. I really didn’t mean it.”

Chen Qi nodded lightly: "Uncle, I believe you didn't mean it, but you..."

 Before Chen Qi finished speaking, Xiao Minghao got sick again and cursed loudly: "Idiot! Stupid woman!"

Then he turned over, exposed his **** to everyone, and slapped it a few times, deliberately saying that you are all big stinkers.

 Chen Qi stood up, watched Xiao Minghao's "performance", and then turned back to the many doctors and reminded:

"Everyone has just seen that when the child is conscious, he behaves well-behaved and even expresses regret and embarrassment for his actions. Although he knows it is wrong, he cannot control his words and actions. Do you think this is a disease?"

 The friendly conversation between Director Chen and the child just now, as well as the child's cursing when he got sick, were seen by everyone.

 At this time a doctor said softly:

“This is not like a petit mal seizure. Petit mal seizures can also include twitching and abnormal behavior, but they are not aggressive or full of swear words.”

 Another doctor also wondered:

“The child has no history of head trauma or encephalitis. It seems difficult to diagnose from the perspective of neurological diseases, and the child’s performance has far exceeded the clinical manifestations of tics.”

Another doctor said firmly:

“I think it’s still a mental illness, otherwise it can’t be explained that just a moment ago he was speaking in a soft voice, and then he turned to filthy words. This switch is not like an organic disease at all.”

 Chen Qi looked at Director Xia Hua:

“Director Xia, what do you think is the cause?”

Director Xia chuckled and shook his head:

"This is really confusing to me. I have also tried diagnostic drugs, but all failed. Dean Chen, I think you seem to be quite confident. Why don't you tell us?"

Everyone's eyes were on Chen Qi, the miracle doctor's diagnosis was always unexpected.

Chen Qi did not hide anything, nodded and said: "There are indeed two diagnoses."

“I think Tourette’s syndrome is more consistent, and the other possibility is Huntington’s disease which cannot be ruled out.”

As soon as Chen Qi finished speaking, all the questions that appeared in the minds of both the doctor and the patient’s family members were questions.

Director Xia Hua knew that the dean was well-informed and his knowledge reserve was among the top in the world, so he smiled and said:

“Come on, while the parents are here today and there are so many doctors, Mr. Chen, tell us what Tourette’s syndrome and Huntington’s disease are.”

 Chen Qi was in a good mood, so he stood there and started telling stories.

“I once watched a movie abroad, the name of the movie was “Call Me Number One”.”

(Actually, this is a 2001 movie, which didn’t exist in this era, but no one investigated such a trivial matter, and Chen Qi also fooled around.)

“The male protagonist of the movie is named Brad, who is also a primary school student and has suffered from a special congenital disease since he was a child.

This is a severe spastic disease that causes him to twist his neck uncontrollably and make strange noises. Even in class, he often screams suddenly or knocks over his desk, seriously affecting other students.

 This kind of weird behavior made him not understood by the people around him since he was a child.

Teachers often criticized him in school, and his classmates even ridiculed him. Even his father, after educating his son over and over again, was extremely disappointed in him when he saw that his son had not corrected himself.

Because Brad couldn't restrain himself from making strange noises, he was considered by the school to be an undisciplined bad boy. Not only did the teachers not understand him, but his classmates also made fun of him for his behavior.

 So Brad spent his elementary and middle school years being misunderstood and lonely.

 But his grades have always been very good, and his intelligence is obviously not affected.

 After graduating from college, Brad went to various schools to interview for teaching positions with the idea that every student deserves to be taught and wanted to be a teacher.

But every time he was interviewed, school officials were always suspicious of him because of his weird symptoms, and clearly told Brad that if he wanted to be a teacher, he couldn't make weird noises or do weird actions during class. Only then would he be hired.

 But Brad is ill and cannot control his behavior at all, so there is no way to get a job.

These various reasons made him feel frustrated, but fortunately his mother always supported and encouraged him, allowing him to face life bravely and overcome difficulties. In the process, Brad also gained love.

 Finally, after interviews with about 25 schools, an elementary school was willing to hire him as a second-grade teacher with a one-year contract.

And Brad also used his various efforts to prove that he is very suitable to be a teacher, and he has a very harmonious relationship with students. In the end, he was even selected as the outstanding new teacher of that year.

 Brad has had a difficult life, constantly battling illness.

  His mother always cheered him up and encouraged him not to compromise with the disease. After the pain, he still maintained an optimistic attitude and bravely faced the cruel reality. He overcame many difficulties and obstacles and tenaciously defeated the disease.

To be precise, this is an inspirational movie, but it was this movie that gave me a great inspiration. "

Zhong Hengyuan said excitedly:

“Isn’t this Brad my son? The protagonist in this movie is exactly the same as my son. Dean Chen, tell me, what disease did the child in the movie get? How was he cured in the end?”

 Everyone’s eyes suddenly focused on Dean Chen again.

Good guys, it turns out that being a doctor requires not only reading a lot of books, but also watching a lot of movies. Can you solve a case and diagnose a difficult and complicated disease by watching movies?

Chen Qi smiled and said, "In the movie I'm talking about, the protagonist suffers from Tourette's Syndrome."

"Tourette's syndrome?" Apparently even a director-level doctor like Xia Hua had never heard of it, let alone the patient's family.

"Tourette's syndrome, also known as Tourette's syndrome, is named after French neuroscientist Jean-Martin Charcot, who named Tourette the intern who first discovered Tourette's syndrome. The disease became known to the world after he published a description of nine patients with "convulsive tic disorder."

 Chance player Chen clicked on the intern who was listening on the outermost side and said with a smile:

"Did you hear that? The Tourette syndrome I'm talking about was discovered by interns. It means that interns can also think independently and publish medical papers independently. But like you, you hide in the back and never see the patients. Is it possible to discover any unique patients?”

Several intern doctors blushed when they heard this.

But not all interns are Buddhists. Those who wanted to make progress took the opportunity to squeeze forward, including the ponytail girl who asked the question before.

 Chen Qi smiled and continued to explain to everyone:

"Tourette Syndrome, a name that nicely sums up the most severe manifestations of the disease, the uncontrollable tics and Tourette syndrome. Sudden, brief, intermittent movements or sounds are the hallmark signs of Tourette Syndrome .

Tics are divided into simple tics, which involve a limited number of muscle groups. Another is complex tics, which involve several muscle groups. There are many symptoms, both simple and complex, found in people with Tourette syndrome.

 Simple tics include blinking, shaking the head, shrugging, eye darting, nose twitching, mouth movements, grunting, coughing, and throat clearing.

Complex tics include repeating observed movements, touching or smelling objects, walking in certain patterns, obscene gestures, bending or turning the body, jumping aimlessly, repeating words or phrases spoken by oneself or others, and saying vulgar and obscene things. Or curse words.

With the benefit of hindsight, let’s take a look at this kid’s name, Zhong Minghao, right? Parents, you know your sons best. Think about it, do the points I just mentioned apply to your son? "

Zhong Hengyuan and Du Wenjuan nodded excitedly:

“Yes, yes, yes, Dean Chen, you are like a god. You described my son’s condition so accurately and so severely. Are there any risks or dangers to this disease?”

 Chen Qi felt a little proud when he heard his parents' affirmation. He used the knowledge from the previous life to act as a miracle doctor in this life. It was so **** satisfying.

However, in order to maintain his superior demeanor, Chen Qi still pretended to smile.

“Normal people may find it strange that they can’t control their movements and words. In fact, they really can’t. Many patients say that it’s like sneezing to them and they can’t help it.

 Before the onset of tics, the patient will have an uncomfortable physical sensation, also called a premonitory impulse, such as itching, tingling or tension. This feeling can only be relieved after the onset of tics.

 Aggravated by illness, stress, anxiety, fatigue, or excitement, Tourette syndrome often causes behavioral and social challenges that can damage the person's image.

 In addition, this disease often appears in children and adolescents, so it may also cause other diseases. For example, attention deficit hyperactivity disorder and obsessive-compulsive disorder, which are often confused with tics, as well as learning disabilities, sleep disorders, depression, etc.

 At this point, we can really describe it as a mental illness, and this process is irreversible, which is one of the biggest dangers.

Another danger is that many people have not heard of this disease and naturally do not think of their children’s tic symptoms as diseases. Most people think that their children have developed bad habits.

 Some parents are more patient and will take the trouble to correct their children's behavior or seek psychological treatment. But some parents may directly use violent correction.

 So I was thinking before that child Zhong Minghao is lucky because as parents you understand him very well and do not put more pressure on him.

If you, as parents, don't understand and beat your children when the teacher comes to complain, or you are very strict and require your children to be obedient, otherwise you will punish them in any way, then today's child Zhong Minghao's condition will only get worse. "

When Zhong Hengyuan and Du Wenjuan heard this, they felt relieved and were glad that they had not done anything drastic to hurt their son before.

 So parents play a really big role in their children’s education. Don’t beat or scold their children at will, including when doing homework and when sending out report cards. (End of chapter)

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