Emily-Epilepsy-(Australia)

Name: Emily     
Sex: Female
Country: Australia
Age: 13 years
Diagnosis: 1. Chronic Encephalopathy (Cerebral Palsy)    2. Epilepsy
Date of Admission: June 29th, 2015
Treatment Hospital/Period: Wu Medical Center/28 days

Before treatment:
Emily was born at 38th week of pregnancy by natural labor. When she was one and half month old, she had single myoclonus. At 3 months old, her body became stiff without obvious inducement.  Adrenocorticotrophic hormone was used and her diet was adjusted. She did not experience stiffness again. From the time when she was a year old, she has been taken anti-epileptic medicine such as levetiracetam and clonazepam. When she was 2-3 years old, she always experience sour regurgitation and hiccup. So she was given lansoprazole for treatment of the sour regurgitation and hiccup and her condition was improved. However, she still had tetanic spasm of four limbs. She cannot recognize her family. She could not pronounce, raise up her head or keep to a sitting position. She had a poor understanding. In 2013, Emily came to our medical center to have treatment for nerve repair and regeneration. After the treatment, the muscle tone of four limbs has been alleviated, the muscle strength of waist and back has improved and the understanding was better. 

Admission PE:
Temperature: 36.4 degree； Bp: 111/79mmHg; Br: 22/min; Hr: 107/min. Her height was 130.5cm and weight was 25.5Kg. The skin and mucosa were intact and had no yellow stains or petechia. Her thorax was symmetrical. The respiration of both lungs was clear, with no dry or moist rales. Her heart rhythm was fast but regular, without obvious murmur in the valves. The abdomen was soft with no rebound tenderness. The liver and spleens were normal during palpation.

Nervous System Examination: 
Emily was alerted and the development of her intelligence was slow. She reacted when she was called. She could cry but had speech dysfunction. She could only pronounce vowel ‘a’. She could take semi-liquid diet without getting choked or salivating. The diameter of both pupils was 4.0mms, and both pupils were equal in size and round. The pupils reacted normally to light stimulus and there was no nystagmus. She could not follow objects moving in front of her eyes. She did not react to sound stimulus. She could not perform an orderly activity. She had a weak control of her neck which always leaned to right. She could raise her head temporarily but she could not keep to a sitting position. She could turn her body at a small range but could not turn over her body herself. The knee joints had some contracture so she could not stand or walk independently. Her heels could not be grounded if she was assisted to stand but she could move her legs. Her hands had difficulty to grasp objects. She could not perform muscle strength examination of her four limbs. Bilateral wrist and ankle joints had a muscle tone that was higher than normal, while the muscle tone of other parts of body was normal. The tendon reflex of upper limbs was normal while the tendon reflex of lower limbs was more active than normal. The bilateral ankles had a postural clonus. Wearing on the orthosis, her feet could be grounded. The Babinski sign of right side was positive. She could perform rapid-rotation test, finger-to-finger test, knee-shin-heel test and Romberg’s test. 

Treatment:
We initially took a complete examinations of the patient. She was diagnosed with chronic encephalopathy (cerebral palsy) and Epilepsy. We gave treatment to initiate her nerve repair and regeneration. She had four times of stem cell injection including neural stem cells and mesenchymal stem cells. She had treatment to activate her endogenous retinal stem cells, improve circulation, nourish nerves and adjust immune system. This was accompanied with rehab training.

Post-treatment:
After the treatment, the condition of Emily is better than before. She has experience no epileptic seizure. Her height is 132cm and the weight is 26Kg. She had some reaction to sound stimulus. She can raise her head shortly when she hears her name. She has more facial expressions and vowels than before.  Her eyes look more concentrated. The muscle strength of her head and neck, waist and back has improved. She has more control when she sits. The muscle tone of wrist and ankle has been alleviated. The ankle clonus has been alleviated.

E-mails：

Date：2015-11-28

Dear Dr.: I tell the current state of Emily: We did hip radiograph and remains igaul than before, there's even a small improvement. The indication of Dr. Anderman. Is to continue with standing and walking with long boots. As we showed you, we're doing every day listening, 2 children's songs with vocals and lyrics. We were able to get off medication without drawbacks, you are taking 1 tablet 125mg of valproic acid in the morning and 1 and a half at night (it was down half a tablet) and Keppra take, 3/4 tablet in the morning and 1 and 1 / 4 night (it was down 1/2 tablet. The rest of medication continues all the same, as you indicated. Eats and sleeps very well and is gaining weight well and improves muscle mass. It also improved posture, core strength and sustenance and mobility of the head, he is now sitting with minimal assistance. We discovered that you can process a single order. It also improved its connection with the environment, people and their interest in the environment, so its look and facial expression. We will be HOLIDAY in Uruguay from 3 to 19 December and we will not be able to use this mail during that time, but upon returning, we will get in touch with you. I send a picture

Date:2015-12-20

Estimated: since we returned from our vacation in the city of Piriápolis in Uruguay. It is a beautiful place with sea, sun and pure and fresh air.
Emily was great and we all really enjoyed these days off.
Now to continue working and Elisa with their therapies.
We wish you and the entire team of Wu spend a Merry Christmas !!
We keep in touch, a warm greeting: Daniela.

Date:2016-3-6

Estimated: Thursday Emily had control with the neurologist and the traumatologist and both looked very good improvements in Emily.
The neurologist told us that the EEG indicates that still has an epileptic focus in the right frontal area, which should keep taking antiepileptic medication, doses are minimal but also the rest of his brain is functioning better, there are improvements in the EEG.
He enconró more strongly in the trunk, head good bra that is attentive and more connected with the environment and is sitting with very little assistance.
The traumatologist found it very well, without retractions, his column is okay, has compensatory curves but within normal, his left hip improved much since, 42% of descobertura of the femoral head, now only 30% and they found clinically well.
The blood análisi are perfect.
His indications were that we continue as before, with todala stimulation that we stop and do walk their long boots, to continue with medication and perform control within a year.

Thank you very much for everything, I hope your reply sincerely: Daniela.

Date:2016-4-18

Dear Dr Peng:

I send reports Emily therapies with the progress they saw in these months after treatment.
Also I send a photo which shows that Emily is running sitting alone or with very little assistance for a few minutes.
Psychomotor report: (4 weekly sessions)
- Improvements in cervical muscle tone in the middle and upper part of the column, which allows Emily has increased the support of the head in a more upright position without constant fluctuations and the need for adults to mold the same correct posture. this in turn increases the near visual field and allows other spatial dimensions.
-Recover Motivation for bodily games and proprioceptive jumping on trampoline, balls, elastic and vibration games that allow you greater body control ropes.
-Improvements progressive in eye contact with the adult, increasing lateral visual ranges, both familiar faces as bright, bright or contrasting objects.
-Start Auditory-visual search to familiar voices and sound stimuli (bells, tambourine and music.
-He observed better morale and motivation, more alert moments of physical play.
-Sometimes his behavior fluctuates depending upon your waking-sleep and the times of day, in the morning is less active than in the afternoon, both muscular level and at the level of interaction with people and objects.
Speech Therapy:
Better muscle tone in the muscles related to the cephalic control.
-More Connection with his eyes.
-Increase Your attention to the human voice and decoding intonations and melodies of language.
-Motivation By communicative exchanges, demonstrating pleased when the other speaks and responding with facial expressions and gestures.
Kinesiology
-In Standing with long leaflets, better posture trunk is observed, needing less physical assistance from the adult.
-In Seated on mat, achieved for short periods of time with senior members support the weight of the trunk and maintain that position.
-Hemipe?vis More challenged right compared to the contralateral.
-More Head tilt to the right, but manages activities in the standing position and take it to align the midline.
 Occupational therapy:
-More Control head against a propioseptive activity.
-can Hold (well organized and previously activated) in semi-hard surfaces sitting longer.
- Now, when something is not interested, although it assists it to look, makes hard to turn your head to the opposite side, unlike last year.
-More Intention to reach and manipulative, facing some games or instructional materials.
-Resistance Manifests the Kinesio-Tape placement.
These reports with the therapists, if I see any questions you experience.
We await your response, thank you sincerely: Daniela.

Date:2016-4-25

Dear Dr: we send photo and video of Elisa working with the occupational therapist, sitting alone.
Please, we would like to show them to the therapists WU (Twoia, Chifon and Bibi) to see their progress.
Thank you very much, sincerely: Daniela.

Date:2016-5-28

Dear Dr.: I send the report of the special teacher accompanying Emily hours Technology, art, music and computer science, in the normal school where it is integrated:
Obsevadas responses during the month of April, compared with 2012:
-More Head control
-Rotated Head to sound stimuli presented to both sides, preferably: Right side
-motions Hand and arm toward the object presented
-Dandole Timeout, touch and stare
He grabs and holds objects offered for long periods exerting pressure with your thumb and forefinger
-Search Physical contact with your hands (and grabs his hand touches teacher)
-responses Gestural and sound to visual, tactile stimuli audutivos, with clear demonstration of liking or disliking

Greetings: Daniela.

Date:2016-5-28

Dear Dr: also noticed improvements in connection Emily, for example:
If we play to tickle him say, "Tell me if you want more AAAA" and she repeated AAAAA to keep playing
If you say, "show me the finger" she shows us or stretch the index finger of the left hand.
-also Asleep noticed that pronounces all kinds of letters and monosyllables, for example, ma, pa ta, eu, fa and others, but only when you sleep, not during the day.
We await your response, cordial greetings: Daniela.

Date:2016-12-2

Dear Dr: Emily weighs 26,500kg, naked, without clothes, shoes or diapers, according to our records increased 3.5kg since we arrived from China, which is a success, never increased so much weight in such a short time.

It measures 1.37m in height.

Keep taking the medication that you indicated and doing all the therapies.

If you have another indication to give us, we will gladly accept it.

Thanks, greetings: Daniela.

Date:2016-12-2

Dear Dr: We send you the results of Emily's blood tests.
Your pediatrician is very happy with the results obtained.
The pediatrician prescribed vitamin D, 1ml every 30 days, also sunbathing and work on vibratory platform. In the left hand radiographic control, the thickness of the cortical bone, the trabeculae, and its hand is growing without bone deformations, which is a surprise too.
The next December 6 we will do a polysomnography and when we have the results we will send them to you.
We look forward to your response, cordial greetings to you and the whole team of Wu: Daniela.

 

 

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