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Francesco - Hypoxic encephalopathy (Argentina)

Author Julia Views Posted at 2014/07/18

Name: Francesco Pidone Belcher

Sex: Male

Country: Argentina

Age: 2

Diagnoses: 1. Hypoxic encephalopathy 2. Secondary epilepsy 3. Upper respiratory tract infection

Admission Date: 2013-01-20

Days Admitted to Hospital: 31 days

Before treatment:

Francesco Pidone Belcher was born through a cesarean section during pregnancy 39 weeks ago. He was hypoxia during the birthing process. The Apgar scoring was 5 points when he was born. This was accompanied with epilepsy and a small crying voice. He was diagnosed with Hypoxic encephalopathy by local doctors. He received medication to control epilepsy, a ventilator to help with breathing, nasogastric tube diet and so on. At that time the patient had no epileptic seizures. Seven days later, the patient's breathing was restored to a normal level. The ventilator was not needed. Then the patient tried to take food from mouth, but the patient's digestive system presented dissection abnormalities. The nasogastric tube was removed 20 days later, and the patient received gastrostomy for treatment. After the operation, the patient took on a liquid diet from a gastrostomy tube. The patient's muscle tone was still higher. The local hospital gave him medication to reduce his muscle tone. The patient also received language rehabilitation and motor rehabilitation. After rehabilitation, the patient's muscle tone reduced gradually. The muscle strength in the neck, waist and both of his lower limbs enhanced gradually. The patient had a big crying voice. At present, the patient has a cognitive disorder, a speech disorder and a motor disorder. He only has an "e-ya" language. He can't call "daddy" or "mama". He also has a defected vision. He can't turn over, crawl, sit up, stand or walk. He can't eat from his mouth.

Admission PE:

Bp: 85/45mmHg; Hr: 76/min. Height: 72cm, weight: 10Kg. There were pink papules found on the arms and legs, the papules were rice sized. The development of bilateral costal arch was abnormal. He had flat feet. The intelligence development was far behind a normal baby. He only could understand simple words. He could excute the parent��s simplest instructions. He only had "e-ya" language. He had obvious cough when he bit and when receiving soup through the mouth. The patient had a fluid diet through gastrostomy tube. There was no red or swollenness found in the throat. There was no enlargement in the tonsils. Through auscultation, there was obvious sputum sound in the laryngeal part of pharynx. The respiration in both lungs was rough. The rhythms of cardiac rate were irregular and there was no pathological murmur in the valves. The abdomen was even. There was a gastrostomy tube in epigastrium. The gastrostomy tube was clean, with no secretion. The abdomen was soft with no masses found. The liver and spleen were not touched. There was no swelling in the lower limbs.

Nervous System Examination:

Francesco Pidone Belcher was alert. He could only understand simple words. There was no autonomous language ability or voice. He couldn't cooperate with the memory, calculation ability or orientation examinations. Both pupils were equal in size and round. The diameter of both pupils was 3.0mms and both pupils were slow to light stimulus. The right eye couldn't outreach and it had esotropia. The left eye was normal. The corneal reflex was found. The eye movement was not cooperative. Other cranial nerve examination was not cooperative. The muscle strength of neck was weak. Occasionally, he could raise his head, but only could maintain it for several seconds, with no resistance. He was unable to tunrn over by himself. He was unable to cooperate with the examination of muscle strength of the four limbs. The patient's four limbs had autonomic activities when he was in a horizontal position. Both upper limbs could bend slightly. Both hands could make a fist. The hold power was about level 2. The muscle tone of both upper limbs was about level 3. The muscle tone of both lower limbs was about level 4. The muscle tone of wrist joints, ankle joints and knee joints was higher than normal. There was difficulty with bending joints. Although with some assistance, the patient still couldn't maintain a sitting position and couldn't turn over. The tendon reflex of both upper limbs was normal. The tendon reflex of both lower limbs was normal. The abdominal reflexes could be elicited. Bilateral Hoffmann sign was negative. The sucking reflex and bilateral palm jaw reflex were negative. Left side Babinski sign was positive, right side Babinski sign was negative. He couldn't cooperate with the sensory examination, finger-nose test, rotation test or the heel-knee-shin test.

Treatment:

Francesco Pidone Belcher received a complete examination. He received treatment to improve the blood circulation. He also received treatment to nerve repair and nerve regeneration. This was accompanied with physical rehabilitation.

Post-treatment:

The upper respiratory infection has completely recovered. Through auscultation, there is no obvious gurgling with sputum. The digestive ability is enhanced. The patient has richer diet than before throguh gastrostomy tube. He eat milk, fruit juice, pumpkin juice and vegetable juice through gastrostomy tube. The muscle strength of neck is better than before. He can raise head by himself and maintain a longer time. The patient can turn over by himself with calling up of parents. The muscle tone of both upper limbs is reduced than before. The muscle relaxant medication has been reduced gradually and has stopped the medication. The muscle tone of both upper limbs has reduced than before. The flexion degree of both upper limbs is alleviated. Both hands are more relax and expand more time. The muscle tone of both lower limbs is lower than before. With some assistance, the patient can sit with knees bent.

Francesco's parents email to us:

Date: March 15, 2013

Anne sent you here Francesco blood studies and also we did an electrocardiogram to control. We look forward to any order yours. A big greeting to all.In addition to Francesco I tell this to all rehabilitation sessions and bottle feeding by mouth is about 100 ml. also a time to pass along their gastric button.

Date: Apr 16, 2013

hi all. we want to see if you need to send them back the blood tests for control of Francesco.

Francesco is very well, avansando day to day with their therapies.

A big salute to all and await your response

Date: Aug 28, 2013

Hello everyone

Here we send the studies that were performed to Francesco days ago. We apologize for the delay but for reasons of nutrition devimos make some changes that we demanded a long time.

Today it is in perfect condition with feeding through a food infusion pump with more nutrients that allowed him to increase 2 kg.

The rest of the medication continues as you guys said it before returning to Argentina.

We await your response and would like to know if they can give us some recommendation from a second stem cell treatment or some comment.

Warmly greet you and thank you from here forever.


 

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