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Luqman - Post encephalitis (Iraq) Posted on July 20, 2012

Author Julia Views Posted at 2014/01/13

Name: Luqman Yaseen Mohammed LK
Sex: Male
Country: Iraq
Age: 42
Diagnosis: Post encephalitis
Admission Date: June 01, 2012
Days Admitted to Hospital: 29

Luqman suffered from sudden and server headaches beginning 12 years ago, then the pain spread throughout the rest of his body. He also had a fever with a high temperature of 42 degrees. There were also convulsions, decline in memory and an inability to speak. Luqman went to his local hospital and was diagnosed with encephalitis. After being treated, the fever and pain was alleviated and the spasms were not as severe. He felt weak, but was still able to walk. One month later, the walking ability started to gradually decline and soon after, Luqman was only able to speak a few words. After some time the speaking ability improved, but he still spoke with a lisp and would occasionally forget some words. During this time, Luqman did not participate in physical therapy and took some medications, but there were no significant improvements. He went to the hospital for treatment in March 2012. After being discharged from the hospital, his speaking became clearer and his responses were quicker. The diplopia came and went. The flexibility of the arms improved. The muscle tone in both legs was reduced, but the condition fluctuated.

Nervous System Examination:
Luqman was alert and in good spirits. His responses were almost normal. The speech was almost fluent, but he would occasionally mumble his words. The patient's memory and orientation were almost normal. The calculation abilities were slightly poor. The patient felt dizzy when changing body positions. The left hand would become numb when the patient laid on his right side. Both pupils were equal in size and round, the diameter was 3.0mms. Both eyeballs could move flexibly and the pupils reacted normally to light stimulus. The binocular vision was almost normal. There were no convergence defects with the eyes. The uvula was shifted to the right side. The neck had flexible movement. The shoulder muscles were strong and had strong shrugging and turning ability. The muscle strength of both upper limbs was level 5 and the muscle tone of both upper limbs was normal. The muscle strength of both lower limbs was level 4 and the muscle tone of both lower limbs was higher than normal. The lower limbs had obvious tremors when the patient stood up. He had difficulty raising up crooked knees, the right lower limb was more severe. The patient could turn over and sit up, but in an awkward manner. He was unable to stand independently. With some assistance, the patient could stand, but the stability of the waist and knee joints was poor and he needed assistance on waist and knees. The sensation in the left side of the face was decreased. The sensation in the right side of the trunk was decreased. The sensation in the right limbs was decreased. The bilateral abdominal reflexes were sensitive. The tendon reflexes of both upper limbs were normal. Both lower limbs had hyperreflexia. The bilateral sucking reflex, palm jaw reflex, Hoffmann's sign and Rossolimo's sign were negative. The bilateral Babinski's sign was positive. The ankle clonus was positive. Both sides could finish the rapid rotation test in a flexible manner. The bilateral finger-to-nose-test was stable. The patient couldn't cooperate with the heel-knee-shin test.

Treatment:
We initially gave Luqman a complete examination, and he was diagnosed with post encephalitis. He received treatment to improve the blood circulation in order to increase the blood supply and nourish the neurons. He also received neural repair treatment.

Post-treatment:
The stability of the waist and knees has increased. The patient can stand with the assistance of a walking aid. He walks about 5 meters. The dizziness when changing body positions has been alleviated. The distance of the bilateral diplopia image and ontology is shortened. The largest distance of the left side diplopia image and ontology was 2cms. The largest distance of the right side diplopia image and ontology was 3cms. The tremors in both lower limbs have been alleviated when the patient walks. He can raise crooked knees more easily. The left side can finish the action. The right foot is unable to rest on the bed surface when the right knee is bent. The left side can finish the heel-knee-shin test, but in an unstable manner.

Luqman's family member emailed to us:

Date: 2012/7/30

Dear Dr. Wang!

Luqman has told me that he has to report back to you r regarding his illness. so he asked me the following to be reported

1. he said that there has been good results in his back strengthening.
2. he said that his leg is becoming better that before but still not well enough.
3. you have given him a bottle of protein but he wants to continue on.

I will be reporting to you all new changes.

Regards
Balien Abdullah

2012/10/22

Dear Dr Wang.
It has been a long time.
there are four points about Luqman that I want to write for you, three of them are about improvements, while the last one is deman and clarifications.

improvements
1. Head Dizzy is no more there.
2. in the past his energy were going down totally, but now when it goes down it stops at some point, so there are improvement.
3. in past, his hands were getting stuck and numbed, but now his hands are normal.
and he can walk about 12 meters if he depands on sticks or helped by someone, but he can not make it alone.
Clarification and demand

Regards
Balien Abdullah


 

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