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Carol Bell-MND-(England) Posted on Mar.31th,2015

Author Zhangqi Views Posted at 2015/03/31

Name: Carol Bell             
Sex: Female
Country: England
Age: 73 years
Diagnosis: Motor Neuron Disease: Progressive Bulbar Paralysis
Date: Mar. 10th, 2015
Days Admitted to Hospital: 14 days

Before treatment:
The patient was difficult to speak with no reason. 2-3 months later, it was more difficult for her to speak, and she could hardly swallow and chew. She had dribble, four limbs were weak and easy to be tired. She went to the local hospital and diagnosed as” Progressive Bulbar Paralysis” based on her medical history and examinations. She took medicines but got worse. It was more hard for her to eat and swallow. She had gastrointestinal gastrostomy to kept her nutrition. She can’t speak or eat, she is hard to breathe. Her four limbs were weak, and she can hardly care herself. She wants to have a better treatment, so she came to our hospital and she was diagnosed with “Progressive Bulbar Paralysis”.

She was in bad spirit. She lost weight, had gastrointestinal gastrostomy, bad sleep. Her urination and excrement were good.

Admission PE:
Bp: 129/86mmHg; Hr: 85/min. BT: 36.2 degree, RP:25/min. Height: 167.5cm, weight: 66.5 kg. The skin and mucosa were normal, with no yellow stains or petechia. There was old surgical scar in the middle of her neck. Her thorax was symmetrical, she had ecphysiesis and the rate of respiration was weak.  The respiration of both lungs was lower, heart rhythm was normal, without no obvious murmur in the valves. The abdomen was bulge and swollen. Percussed with tympany, her abdomen was soft with no tenderness or rebound tenderness. The liver and spleen were normal. There was mild dropsy on both lower limbs.

Nervous System Examination:
Carol Bell was alert and less spirit. Her memory, calculation and orientation abilities were normal. The diameter of both pupils was 3.0mms, both eyeballs could move freely and the pupils reacted normally to light stimulus. Both eyes had horizontal nystagmus. Poor binocular convergence. The forehead wrinkle pattern was symmetrical. She had strength to close his eyes, Both nasolabials were equal in depth. she couldn’t move her tongue flexible. The tongue muscular atrophied. Cheek blowing strength was low, both soft palates couldn’t lift, pharyngeal reflex was normal. she was hard to cough, had dysarthrosis. The muscle power of left side was at level 3+, right side was at level 4. Four limbs muscular atrophy, especially left side. Intermittency fasciculation, activities endurance was weak. She was easy to tired. The muscle tension of four limbs were normal. The tendon reflex was normal. The abdominal reflexes was abnormal. Both side palm jaw reflex was positive, both side Hoffmann sign and Rossilim sign were negative. Both side Babinski sign was neutral. The rough depth determination of both sides were normal, finger-nose test, rapid rotation test and heel-knee-tibia test were normal. The meningeal irritation sign was negative.

Treatment:
We diagnosed Carol Bell based on the history of disease and past examination as: Motor Neuron Disease: Progressive Bulbar Paralysis. She received treatment for nerve regeneration and to activate stem cells in the body. She received treatment to improve the blood circulation in order to increase the blood supply to the damaged neurons and to nourish them. We also gave her daily physical rehabilitation.

Post-treatment:
After the treatment, she was in good mental state. Her pronunciation was more clear than before. The movement endurance was improved. Her breath was normal, 19-22/min. She dribbled less. Gastroesophageal reflux was less. The muscle power was better than before. The abductor muscle power of left upper limb was at level 3+, the extensor muscle power of left upper limb was at level 3+. The flexor muscle power of left upper limb was at level 4. The left hand grip was at level 4. The abductor muscle power of right upper limb was at level 4, the right side extensor muscle power, flexor muscle power and grip was at level 5. The muscle power of left lower limb was at level 3+, right side was at level 4+. Both lower limbs didn’t dropsy.

 

 


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