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Sergei Ugriumov-CMT-(Russia)-Posted on Apr.29th,2015

Author Zhangqi Views Posted at 2015/04/29

Name: Sergei Ugriumov               
Sex: Male
Country: Russia
Age: 46 years
Diagnosis: Charcot Marie Tooth disease
Date: Apr. 5, 2015
Days Admitted to Hospital: 19 days

Before treatment:
Sergei Ugriumov experienced lower limbs weakness in 2006 with no apparent cause. His walking ability was affected and it became worse. He had full examinations in a local hospital and was diagnosed as peroneal muscular atrophy by gene analysis. His condition got worse. The muscle power of his upper limbs became weaker which was accompanied with muscular atrophy. He had auto-transplantation of cells and there was no improvement. His disease had further deteriorated, he had difficult to walk and getting on stairs. He easily gets tired, the distance he could walk was shorter, it became 2 km from 5 km, and his lower limbs hurt after exercise. He could care for himself and he would fall if he is over tired. He wants to have a better treatment, so he came to our hospital.

He was in good spirit. His diet, sleeping, drink, urination and excrement were normal. His weight was normal.

Admission PE:
Bp: 146/90mmHg; Hr: 66/min. BT: 36.6 degrees, RP: 19/min. He was well nourished and tall. The skin and mucosa were intact with no yellow stains or petechia. His pharyngeal was intact with no congestion, both tonsils were normal. The respiration of both lungs was rough, with no dry or moist rales. His heart rhythm was normal and strong, without no obvious murmur in the valves. The abdomen was flat and soft with no tenderness or rebound tenderness. The liver and spleen were normal. The muscle of both forearms, both hands, both calves and both thighs were atrophied. There was no dropsy on both lower limbs.

Nervous System Examination:
Sergei Ugriumov was alert and in good spirit. He spoke clearly. His memory, calculation and orientation abilities were normal. The diameter of both pupils was 3.5mms, and both pupils were equal in size and round. Both eyeballs could move freely and the pupils reacted normally to light stimulus. The forehead wrinkle pattern was symmetrical. Both nasolabials were equal in depth. The tongue was in the center of the oral cavity, with no teeth deflection. Both soft palates could be lifted strongly, pharyngeal reflex was normal. The muscle power of both upper limbs was at level 5-, both lower limbs was at level 4. The muscle tension of both upper limbs was normal, both lower limbs was a little lower. The tendon reflex of both upper limbs was normal, both lower limbs was a little lower. Both side abdominal reflexes were normal. Both palm jaws reflex were negative. The pathological sign was negative. The rough depth determination of both sides were normal, finger-to-nose test, finger-to-finger test and rapid rotation test were normal. Both side heel-knee-tibia test was normal. The meningeal irritation sign was negative.

Treatment:
We diagnosed Sergei Ugriumov based on the examination as Charcot Marie Tooth disease. He received treatment for nerve nutrition, improving blood supply, increasing nerve regeneration and also to improve muscle nutrition. We also gave him daily physical rehabilitation.

Post-treatment:
After the treatment, both hands were more powerful than before, the muscle of thenar was fuller than before. The exercise tolerance was better. The distal of lower limb’s muscle power was better than before. The dorsum of the foot could do dorsiflexion, and the amplitude was bigger than before. Balance ability in standing was better and he could walk well. After exercise his lower limbs were less painful than before. His treatment was over and discharge was permitted.


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