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Md.Zilkad Rahman Sabab - Cerebral palsy (Bangladesh) Posted on November 3, 2014

Author Tracy Views Posted at 2014/10/23

Name: Md.Zilkad Rahman Sabab 
Sex: Male
Country: Bangladesh
Age:6 years
Diagnoses: Cerebral palsy, Epilepsy
Date: October 06, 2014
Days Admitted to Hospital: 14 days

Before treatment:
The patient's mother felt fetal movements were reduced obviously when she was 9 months pregnant. She went to a hospital and found out that there was fetus intrauterine hypoxia. The patient was born through cesarean section. The patient suffered from breathing difficulty after birth. The patient was kept in ICU for 1 month. His breathing and diet were normal after discharge. The child's head was enlarged when he was 4 months old. He screams and cries. He went to a local hospital and received CT examination, the hydrocephalus was detected. He received ventriculoperitoneal operation. After the operation, the patient was restored to normal. The patient suffered epileptic seizure when he was 1 year old. He received phenobarbital, Kaplan and oxcarbazepine for treatment, the epilepsy was out of control. The epileptic seizure lasted from 20 seconds to 1 minute and about 3-4 times each day. The patient went to another hospital in May and the antiepileptic drugs were adjusted. The epileptic seizure has reduced in recent 5 months. About 1-2 times each week. The patient also received rehabilitation for speech, language and limbs, but the effect was not good. Before the treatment, he only could pronounce "A", "Yi" and "Wo". There was no specific language he could express.  He had chewing difficulty. He ate liquid diet and swallow ability was poor. He coughs when he drinks. Both pupils were equal in size and round. The intelligence development and motor function development were delayed. He had no obvious communication with others. He could move his eyes when his name was called. He could support his head for a short time. He was unable to turn over, sit - up, stand or walk. There was no activity of four limbs.

From the onset of disease, the patient had normal diet. He defecated every day. The urine was normal. There was no genetic disease.


Admission PE:
BP: 90/50mmHg, HR: 100/min, temperature: 36.8 deg. Br: 38/min. Height:106cm, weight: 19 Kg. The skin and mucosa were intact, with no yellow stains or petechia. The respiratory sounds in both lungs were clear, and there was sound in throat. There was no dry or moist rales in both lungs. The heart sounds were strong and cardiac rhythm was regular, with no obvious murmur in each vales. The abdomen was flat, with no pressing pain or rebound tenderness. Doctor didn't palpate or touch the liver and spleen under the rib.

Nervous System Examination:
The patient was alert. His intelligence development was slow. He had response when his name was called. He was unable to finish the instruction of family members. He could cry and his language development was delayed. He only could pronounce "A", "Yi" and "Wo". There was no specific language he could express. He had chewing difficulty. He ate liquid diet and swallow ability was poor. He coughs when he drinks. Both pupils were equal in size and round. The diameter was about 3.0 mm. Both eyes were sensitive to light stimuli. He had nystagmus. He was unable to cooperate with the examination of vision and visual field. His neck had poor control ability and only could raise his head for a short time. He was unable to turn over or sit without help. He also unable to stand or walk. He was unable to grasp objects. He was unable to cooperate with the examination of muscle strength. His four limbs had involuntary activity, with no specific grasp action. His lower limbs could be lifted off the bed surface. The muscle tone of both lower limbs was increased slightly. The biceps reflex of both upper limbs was elicited. The radioperiosteal reflex, patellar tendon reflex and Achilles tendon reflex were not elicited. The sucking reflex and palm jaw reflex were negative. Bilateral Hoffmann sign was negative. Bilateral Babinski sign was positive. The ankle clonus was negative. He was unable to cooperate with other examinations.

Treatment:
After admission, the patient was diagnosed with cerebral palsy and epilepsy. He received treatment for nerve regeneration and to activate stem cells in the body.He was given treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and nourishment for the neurons. We also gave him treatment to control epilepsy. This was combined with daily physical rehabilitation therapy.

Date: 2014-11-09

Hello Dcotor,

Hope u all are doing fine, Please pass my love to Dr Wu, Dr.Wang and Team,

I would like to Thanks u all.
Have contract with local test lab for Sabab, suggested test,
They are not clear on below test what points need to be tested
Sexual Gland 3 item, Please ask Doctor to specify the same which point we should ask them for test.

His present condition is improving and we can u/stand, his sitting position is little better.
His Neck condition is more balance and better from earlier, we think, its improving, we thanks to God for his improvements.

I am very concern for his Speech; I can not u/stand improvements in this site, Please ask Dr to suggest.

I have copied in this mail, his Therapist Ms.Israt, who is very lovely for his caring and Therapy.
If required any points to be more care, please ask Doctor to suggest her.

Will update more information at future and I will send you below test report tom by mailing.


Waiting ur reply.

Rgds/Linkon

Date:2014-11-9

Hello Brittani,

Hope u all are doing fine, Please pass my love to Dr Wu, Dr.Wang and Team,

I would like to Thanks u all.
Have contract with local test lab for Sabab, suggested test,
They are not clear on below test what points need to be tested
Sexual Gland 3 item, Please ask Doctor to specify the same which point we should ask them for test.

His present condition is improving and we can u/stand, his sitting position is little better.
His Neck condition is more balance and better from earlier, we think, its improving, we thanks to God for his improvements.

I am very concern for his Speech; I can not u/stand improvements in this site, Please ask Dr to suggest.

I have copied in this mail, his Therapist Ms.Israt, who is very lovely for his caring and Therapy.
If required any points to be more care, please ask Doctor to suggest her.

Will update more information at future and I will send you below test report tom by mailing.

ØBlood Routine
ØLiver Function
ØRenal Function
ØThyroid Function

Waiting ur reply.

Rgds/Linkon

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