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Chrystabel Chipulu - Cerebral palsy and Chorea (Zambia)

Author Julia Views Posted at 2014/01/13

Name: Chrystabel Chipulu

Sex: Female

Country: Zambia

Age: 23

Diagnosis: Cerebral palsy and Chorea

Admission Date: 2013-03-26

Days Admitted to Hospital: 25 days

Before treatment:

Chrystabel Chipulu was born when her mother was 34 weeks pregnant. The patient's weight was less than 2.5Kg when she was born. The patient's breathing, heart beat and sucking ability were normal. The patient suffered from serious jaundice in the first week after birth. After treatment in the hospital, the patient's condition was better. 6 months later, the patient was found to have a slower ability at raising her head and sitting up than age-matched children. She was diagnosed with cerebral palsy. Then the patient received rehabilitation training of the limbs which was not continuous. At present, the patient's intelligence was almost normal. She speaks slowly, but could communicate with others normally. She could sit up and keep a sitting position by herself. She could move from the bed to a wheelchair. She couldn't stand or walk. She couldn't keep her balance in a standing position without assistance. She could raise her hands over her head. She had grasp action, but the action was slow and the coordination was poor. She was unable to finish fine movement, such as writing with a pen, eating with a spoon or drinking from a cup. She was able to go to the toilet, bathe, put on or take off her clothes. She needed a wheelchair in daily life and couldn't move the wheelchair forward.

Nervous System Examination:

The patient was alert and her spirit was good. She spoke slowly, but could communicate with others normally. The orientation and calculation were normal. The memory was almost normal. Both pupils were equal in size and round, and the pupils were sensitive to light stimulus. Both eyeballs were in the normal position. Both eyeballs move freely to each side. The tongue was in the center of the oral cavity and the uvula was in the center. The muscle tone of the neck was normal. She was unable to shrug her shoulders. The muscle strength of both upper limbs' near-end was level 4. The muscle strength of both upper limbs' far-end was level 4+. The hold power of both hands was level 4. The muscle strength of both lower limbs was level 4. The movement of the four limbs was slow and the coordination was poor. The muscle tone of the four limbs was slightly increased. The limbs had obvious associated action, if the left limb does an exercise, the left arm does the same action. There was abnormal involuntarily contraction in the torso, four limbs, face and neck when she does exercise. She showed her teeth when she has a muscle contraction. And there was a twist posture in the head and torso, choreic movement in the four limbs when the muscle contracts. Bilateral abdominal reflexes were elicited normally. Bilateral radioperiosteal reflex, biceps reflex and triceps reflex were normal. Bilateral patellar tendon reflex was normal. The achilles tendon reflex was not elicited. Bilateral ankle clonus was negative. The sucking reflex was negative. Bilateral palm jaw reflex was negative. Bilateral Hoffmann sign was negative. Bilateral Babinski sign was positive. She did the finger-to-nose test, the rapid rotation test and the digit opposition test in an unstable and slow manner. She was unable to finish the heel-knee-shin test. The deep and shallow sensation was normal. There was no meningeal irritation.

Treatment:

After the admission, Chrystabel received the relevant examinations and the diagnosis was clear. The patient was given treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and nourishment for the neurons. The patient also received treatment for nerve repair and nerve regeneration. This was combined with daily physical rehabilitation therapy.

Post-treatment:

The patient's motor function is better. The involuntary movement of the whole body is reduced obviously. The show teeth action in the face is reduced when there is a muscle contraction. The twist of head and torso are more reduced than before. The four limbs are more relaxed than before. The choreic movement is more reduced than before. The stability of the limbs is better. Both hands were able to partly finish the grasp and pinch action. The muscle strength in the neck and shoulders is improved. She is able to finish the shrug action.

2013-12-23

Dear Susan,

Thank you for your note.Christabel's movements have slightly improved. The Physiotherapist is able to do more exercises with her than before. The sense of laterally balancing has improved. She is unable to write.

I was thinking if it is possible for a follow up treatment for 28 days would be possible sometimes next year?.


 

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