Retal Abdulrahman - Retinal diseases (Sudan) Posted on November 27, 2012

Name: Retal Abdulrahman                  
Sex: Female
Country: Sudan
Age: 2
Diagnosis: 1. Retinal diseases, 2. Cerebral palsy 3. Hyperthyroidism
Admission Date: October 20, 2012
Days Admitted to Hospital: 28 days

Before treatment:
The patient was born prematurely when her mother was 26 weeks pregnant. She had difficulty in breathing and hypoxia after birth. The score at the first minute and the 5 minute was 6 and 8. The weight was 1.1Kg at birth. The local hospital gave her treatment to correct hypoxia, maintain organic function stability, nutrition support and maintain body temperature. The patient's respiratory function and body condition was stable. She was diagnosed with retinopathy and didn't receive special treatment. She still couldn't sit up, stand or walk when she was 1 year. And the activity of the four limbs was not flexible. So she received rehabilitation when she was 1 year old. The patient right eye's cornea had vitiligo 7 months ago. The left eye had the same disease 3 months ago. With some assistance, the patient could maintain a sitting position for a short duration. Both feet couldn't touch the ground and couldn't walk. The activity of four limbs was not flexible. Left eye had sensation to light. Right eye had leukoma and the pupil was shield completely. Both eyes couldn't follow objects.

Nervous System Examination:
Retal Abdulrahman was alert. Her speech was clear and most of the speech was repetition. She was unable to express herself. She was unable to cooperate with the examination of memory, orientation and calculation. The right eye had leukoma and the pupil was shield completely. She couldn't cooperate with the examination of pupillary light reflex.The left eye had nebula. The diameter of the left eye was 2.0mm, and had slow responses. Her eyes were unable to cooperate with the vision and visual field examination. Both eyes couldn't follow light or follow an object. The forehead wrinkle pattern was symmetrical. The nasolabial sulcus was equal in depth. She had normal swallow ability. She couldn't cooperate with other examinations. There was flexible movement in the neck. Four limbs couldn't cooperate with the muscle strength examination. The activity of upper limbs was not flexible. Both lower limbs had more autonomic activities. She couldn't turn over, sit, stand, crawl or walk by herself. The muscle tone of all four limbs was almost normal. The tendon reflexes of all four limbs were normal. Bilateral ankle had tendon contracture. Bilateral abdominal reflexes were normal. The sucking reflex was negative. Bilateral sucking reflex was negative, bilateral palm jaw reflex was positive. Bilateral Hoffmann sign was negative. The Rossolimo sign of both upper limbs was negative. The pathological reflex of both lower limbs was negative. She couldn't cooperate with the examination of deep, shallow sensation and coordinated movement examination.

Treatment:
We gave Retal Abdulrahman a complete examination and she was diagnosed with 1. Retinal diseases, 2. Cerebral palsy 3. Hyperthyroidism. She received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and nourish the neurons. She also received treatment to adjust thyroid hormone and strengthen immunity. This was accompanied with rehabilitation.

Post-treatment:
The patient's condition is better than before. If the patient meets hard light, both eyes have a reflection. The left eye can follow light and follow big objects. Right eye had leukoma and the pupil was shield completely. The muscle strength of back and waist are increased. She can support with four points and sits independently for more than 10 minutes.

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