Pollack-Parkinson Disease-(Israel)

Name: Pollack
Sex: Male
Nationality: Israeli
Age: 73Y
Diagnosis: 1. Parkinson disease 2. Diabetes (type2) 3. insomnia
Discharge Date: 2018/01/24

Before treatment:
The patient had tremor in his arms 14 years ago and his condition got worse day by day. He also had problems with moving around. He was diagnosed with Parkinson's disease. After that his condition got worse, he had balance problems 10 years ago, he couldn’t walk well and needed help with daily life. In the past year his condition got worse so he took more doses of Sinemet but without any good effect and he had hallucinations so had to take less Sinemet. He had on-off problems. At present he has static tremor, intention tremor, muscle stiffness and slow movement, he can’t walk, he has facial muscle stiffness, it is hard for him to write and his balance function is bad.
His diet is normal, he doesn't sleep well, his urination and defecation functions are normal and he has had diabetes type 2 for many years.  

Admission PE:
Bp: 150/90mmHg, Hr: 67/min, breathing rate: 19/min. The patient's nutrition status is good with normal physical development. Skin was normal with no bleeding or yellow stains and no tonsil swelling. The chest development was normal, the respiratory sounds in both lungs were clear and there were no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was bulging and soft, with no masses or tenderness but with percussive tympany. Liver and spleen were normal by touch and there was no edema of the legs.

Nervous System Examination:
Patient was alert and had slurred fast speech with a low voice. His orientation and calculation abilities were normal . Facial expression was reduced and blinking was reduced. Both pupils were equal and round, diameter of 3.0mm, react well to light, the eyeballs can move freely and there was no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, there was tongue muscle tremor and he could not move his tongue freely. He could make his tongue extend out to the lip on the side but his tongue could not touch his cheek. The bilateral soft palate could lift powerfully and the uvula was in normal position. Patient's neck was stiff and he could turn his head slowly. The 4 limbs had slow movement with static tremor with the right side much more severe. The arms had  intentional tremor, the 4 limbs muscle power was 4 degrees. The patient could not roll over in bed, get up from bed, stand or walk. The  muscle tone of the arms were normal, the leg muscle tone was increased. Bilateral biceps reflex, triceps reflex, radial periosteal reflex, patellar tendon reflex and Achilles tendon reflex could not be induced by examination. The bilateral Hoffmann sign, Rossilimo sign of both sides, sucking reflex, Palm-jaw reflex of both sides and the  Babinski sign of both sides were all negative. His sensory examinations were normal including the deep and superficial sensory and fine sensory system. His finger opposite movement and finger to nose test were not correct or stable, the bilateral fast alternate movement were clumsy and he could not perform the heel-knee-tibia test. The Romberg's sign was positive and the meningeal irritation sign was negative.

After the admission he received 3  nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

After 14 days treatment he spoke louder and clearer, his facial expression was much more natural, his blink action was better and his neck became softer.. The limb movements were much more flexible, his slow movement symptoms alleviated, the gait was much better than before and he can now walk 50 meters. He could perform the coordinate movement and fast alternate movement tests much better than before and his balance control ability was improved.

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