John Beattie-Parkinson Disease-(Australia)

Name: John Beattie
Sex: Male
Nationality: Australian
Age: 71Y
Diagnosis: 1. Parkinson Disease 2. Hypertension (2 degree) 3. Diabetes (type 2)

Before treatment:
The patient had right hand tremor 4 years ago, his right leg was stiff 2 months later so he went to hospital and was diagnosed with Parkinson disease. He took Madopar to control his disease but his condition became worse. He felt stiffness in body but it became better after taking medicines. At present, he feels stiffness in the right side of his body, his walking position is abnormal, he walks fast but is unstable, his facial expression is reduced and he also has tongue muscle tremors.
His diet, sleep and weight are normal. He wakes up some times during sleep. His urination and defecation functions are normal.

Admission PE:
Bp: 134/75mmHg, Hr: 80/min, breathing rate: 19/min. height 172cm, weight 80Kg.
His gait was slightly unstable, nutrition status was good and he had normal physical development. There is no injury or bleeding spots of his skin and mucosa but there was generalized skin eruption, red maculopapule, no furfur, skin surrounding was normal. There was no congestion of the throat and no tonsil swelling. The breathing sounds of both lungs were clear with no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no murmur. The abdomen was soft and flat with no masses or tenderness. The liver and spleen were normal, shifting dullness is negative. The spinal column is normal and there was no edema in the legs.

Nervous System Examination:
Patient was alert, clear in his speech but speaking speed was slightly faster than normal. His memory, orientation and calculation abilities were normal. Facial expression and blinking was reduced. Both pupils were equal in size and round, diameter of 2.5 mm, react well to light, eyeballs can move freely and there was mild horizontal nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, showing the teeth is normal, tongue is in middle with tongue muscle tremor, the tongue could move well, soft palate can lift powerfully as normal and the uvula was normal. He could turn his neck powerfully. Arm coordinate movement was not as complete as normal, there was static tremor of the left arm but no obvious tremor of the other limbs. Muscle power of the 4 limbs was 5 degrees. There was no freeze up when he start to walk. His walking speed was faster with a wide pace. Muscle tone of the 4 limbs was normal. Bilateral biceps reflex, triceps jerk and radial periosteal reflex could not be induced by examination, the patellar tendon reflex and Achilles tendon reflex also could not be induced. The Hoffmann sign and Rossilimo sign of both sides were negative. Bilateral Palm-jaw reflex was negative. Babinski sign of both sides were neutral. Sensory system examination including the fine sensory was normal. Right side finger opposite and finger to nose test were not very stable or accurate, both sides fast alternate movement test were clumsy, right side was more severe. The both sides Heel-knee-tibia test were stable, the Romberg's sign was weakly positive. The meningeal irritation sign was negative.

After the admission he received related examinations and diagnosed with 1. Parkinson disease 2. Hypertension (2 degree) 3. Diabetes (type 2). He received 3 times nerve regeneration treatment to anti Parkinson symptoms, nourish nerves and improve blood circulation, control blood pressure, adjust the blood sugar level and lower blood lipid,. This was combined with rehabilitation training. 

After 13 days treatment his blood pressure and blood sugar are stable and fasting blood-glucose is normal. Two hours after a meal his blood sugar is between 8.0~11.0mmol/L. His facial expression was much more natural and the limbs movement was much more flexible. The right side static tremor reduced, the morning stiffness alleviated, his walking was much better than before and the Romberg's sign was negative.

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