Vanessa - Progressive Muscular Dystrophy Before treatment: When Vanessa was 5 years old (12 years ago), she showed weakness of both upper arms and gradually had weakness developing to her waist, back and legs. She had biopsy in Portugal and was diagnosed with Progressive Muscular Dystrophy. She had Solupred as oral medicine but the condition still got worse gradually. 7 years ago she lost the ability to walk independently and at present, she cannot turn over, stand or walk by herself. Admission PE: Bp:110/70mmHg; Hr: 98/min, temperature: 36.2degrees. Br: 18/min. Weight: 41Kg. She was tall and lean. She looks malnourished. Her thorax was symmetrical. Through auscultation, the respiratory sounds in both lungs were clear, with no dry or moist rales. The heart sounds were strong, the cardiac rate was regular, with no obvious murmur in each valves. The abdomen was cup-shaped. The liver and spleen were normal under palpation. Blood test showed CK (creatine kinase) was 1161U/L (0-190) much higher than normal. Nervous System Examination: Vanessa Tchissola Mucangela Garrido was alert, and her speech was fluent. Her memory and orientation were normal. Her calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3.0mms. Both pupils were sensitive to light stimulus. Both eyeballs had flexible movement. The forehead wrinkle pattern was symmetrical. The bilateral nasolabial sulcus was equal in depth. The tongue was centered in the oral cavity, with no teeth deflection. She could raise the soft palate strongly. The muscles of neck, shoulder, neck, waist and back, four limbs have been greatly atrophied. The muscle strength of neck was at level 1+. The muscle strength to shrug shoulders and turn neck was at level 2. The strength of abductor muscles, extensor muscle strength, pronation and supination strength were at level 2-. The flexor muscle strength was at level 3-. The hold power of left hand was at level 3-, the hold power of right hand was at level 3. The muscle strength of both lower limbs was at level 1. The muscle tone of four limbs was low. The tendon reflex was weak. The pathological sign was negative. The deep and shallow sensation was normal. She can complete finger-to-finger and rapid rotation test slowly but she cannot do heel-knee-tibia test and finger-to-nose test. Treatment: We initially gave Vanessa a complete examination. She received treatment for muscle fiber repair and regeneration. She received treatment to enhance his liver function, reduce creatase, reduced blood lipid, nourish the nerves, activate muscle stem cells in the body, stabilize organ function and promote nerve regeneration. She also received treatment to improve the blood circulation in order to increase the blood supply to the damaged neurons. This was accompanied with physical rehabilitation treatment. Post-treatment: The patients condition has improved. The weakness has been alleviated and the exercise endurance has improved. The overall muscle strength improved to between 1-2 levels. The muscle strength of neck was at level 2. The muscle strength to shrug shoulders and turn neck was at level 3. The strength of abduct muscles, extensor muscle strength, pronation and supination strength were at level 2-. The left extensor muscle is at level 2-, flexor muscle strength is at level 3. The hold power of left hand is at level 5; the right extensor muscle is at level 2+, right flexor muscle strength is at level 2+. The hold power of left hand is at level 5. The muscle strength of both lower limbs was at level 1. The CK level has been greatly declined. wumedicalcenter/article/PatientStories/MD/22201411101094.html
Posted on: Tue, 11 Nov 2014 01:28:32 +0000
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