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Bush Suryadinata - Meningoencephalitis sequela (Indonesia) Posted on September 13, 2012

Author Julia Views Posted at 2014/01/13

Name: Bush Suryadinata
Sex: Male
Country: Indonesia
Age: 13
Diagnoses: Meningoencephalitis sequela, epilepsy
Admission Date: May 13, 2012
Days Admitted to Hospital: 28

Before treatment:
The patient was born by cesarean section and was a full-term delivery. The patient had hyperpyrexia when he was 3 years old, with no obvious incentive. The highest temperature reached 38.5-39. His parents took him to a local hospital and received treatment to bring down a fever. The patient's temperature was restored to a normal level gradually and returned home. 2 days later, his family member found the patient had abnormal emotional changes and the sleep time increased obviously in the daytime. The patient was sent to local hospital and had convulsions of the limbs and became unconsciousness on the way to the hospital. Then the patient fell into a coma. The patient received cerebrospinal fluid examination and Eeg examination. The result of cerebrospinal fluid was normal. The EEG showed he had epileptic form pattern EEG. He was diagnosed with encephalitis and epilepsy. He received medication for treatment. After 2 days in a coma, the patient gradually came to himself, but he lost all his memory. About 2 weeks later, some of the patient memory was restored and he could recognize his father, mother and diet. The memory, intelligence and speech ability decreased obviously. He beat his head and chest with both hands and had frequently had epileptic seizures. The period was not regular. The speech function reduced gradually and only could say "Ah". The patient had surgery to reduce the number of epilepsy seizures in the local hospital in August 2011. After the operation, the patient had better emotions and could cooperate with family members. The times when he beat his head and chest were fewer than before. At admission, the patient recognized his family members. The memory, intelligence and speech ability reduced obviously. He had 2-3 times epileptic seizures each day. Occasionally, he beat his head and chest. The movement of four limbs was flexible. The walking gait was abnormal.

Admission PE:
Bp: 116/74mmHg; Hr: 73/min, Height: 155cm, Weight: 33 kg. The patient had normal nutrition. The skin and mucous membrane throughout the body was intact, with no yellow stains or hemorrhagic spots. The thorax was symmetrical, with no abnormalities. The respiratory sounds in both lungs were clear, with no dry or moist rales. Through auscultation it was determined that the heart sounds were strong, and the rhythm was regular. There was no murmur in the auscultatory valve areas. The abdomen was flat, with no pressing pain or rebound tenderness. The liver and spleen showed no abnormalities through palpation. There was no edema in the lower limbs. Bush couldn't run. Bush's mood was unstable and he was easily excitable and hyperactive. The patient would often beat his head and chest. He had a low level of interest in things and had a short attention span that lasted for about 2 minutes. He was interested in small objects.

Nervous System Examination: Bush Suryadinata was alert. He couldn't cooperate with the physical examination. He had a speech dysfunction and could only say "Ah". He had no ability to communicate. His comprehension, memory, calculation abilities and orientation were all decreased. Both pupils were equal in size and round. The diameter of both pupils was 4.0mms and both pupils were sensitive to light stimulus. The patient couldn't cooperate with the movement examination. The right eye had strabismus. The convergence ability of the right eye was poor. There was no nystagmus. The patient couldn't cooperate with the vision examination. The forehead wrinkle pattern was symmetrical. The nasolabial sulcus was equal in depth. The patient couldn't cooperate with the examination of showing teeth, drum cheeks or tongue out. The tendon reflexes of all four limbs were normal. The patellar clonus and ankle clonus was not elicited. The bilateral abdominal reflexes were normal. The bilateral Hoffmann's sign was negative. The bilateral palm jaw reflex was negative. The left Babinski's sign was negative. The right side Babinski's sign was positive. The patient couldn't cooperate with the deep or shallow sensation examination. He couldn't cooperate with the examination of the coordinated movements. There were no signs of meningeal irritation.

We initially gave Bush a complete examination, and he was diagnosed with Meningoencephalitis sequela and epilepsy. Bush received stem cells therapy first. Then the patient received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and to nourish the neurons. He also received anti-epileptic medication. This was combined with daily physical rehabilitation training.

At present, the patient's condition is better than before. He can run. His mood is more stable. The excitable times have been reduced. The hyperactivity has been reduced. The number of times he hits his head and chest has been reduced. His attention span has increased and he can watch TV for about 5 minutes.




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