Joseph Medalie-Parkinson Syndrome-(South Africa)

Name: Joseph Medalie 
Sex: Male
Nationality: South African
Age: 67Y
Diagnosis: Parkinson Syndrome
Discharge Date: 2017/11/07

Before treatment:
The patient had progressive hand tremor and slow movement 22 years ago and he went to a local hospital and was diagnosed with Parkinson's disease. He took Sinemet and felt better so he continued with his work and some years later his condition became worse again. 13 years ago he did DBS treatment and took Sinemet again and his condition became better. 10 years ago he began to take Rasagiline and his condition was stable, he could work as normal. 5 years ago his voice was unclear, he couldn’t speak clearly, he had tremor in his four limbs and onset problems,. He fell down a lot,  had urinary incontinence and sleep disturbance combined with hallucination, cognitive function disorder, night restless legs, akathisia, etc.
His diet is normal, he sleeps over 15 hours a day, he has lost 2-3 kgs in 2 years and he wears diapers. He needs a glycerine enema for defecation every 2-3 days.

Admission PE:
Bp: 124/84mmHg, Hr: 67/min, breathing rate: 17/min, body temperature: 36.1 degrees. Height: 171cm, weight: 72Kg. The patient displays an unstable out-toe gait. Nutrition status is good with normal physical development. There is no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion and no tonsil swelling. Chest development is normal, the respiratory sounds in both lungs were clear with no dry or moist rales. The heart beat is strong with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was soft and flat with no masses or tenderness. The liver and spleen were normal and there was no edema in the legs.

Nervous System Examination:
Patient was alert, has slurred speech and he speaks with a low voice rapidly. His comprehension ability is reduced, his speech could not be understood well, he has poor memory and calculation abilities. Facial expression is reduced, both pupils were equal in size and round, diameter of 2.5 mm, react well to light and the eyeballs can move freely. Bilateral forehead wrinkle and nasolabial groove was symmetrical, he can make his tongue extend out as normal, there is tongue muscle tremor and his tongue cannot move freely. Bilateral soft palate can lift, the uvula was in middle and he can turn his neck powerfully. The arms coordinate movement was not as strong as normal and there is static tremor of the arms. The right leg had static tremor occasionally. Muscle power of the 4 limbs are 5 degrees. He has movement ability for sitting up or walking but with difficulty, the walking speed was fast and the walking pace was wide. He can turn over his body slowly. 4 limbs muscle tone was normal, bilateral biceps reflex, triceps reflex and radial periosteal reflex are normal, the patellar tendon reflex and Achilles tendon reflex can not be induced. The bilateral Hoffmann sign was negative. Rossilimo sign of both sides was positive, bilateral Palm-jaw reflex was negative; bilateral Babinski sign was positive. Sensory system and fine sensory were normal, the finger opposite movement and finger to nose test of both sides were stable, the both sides fast alternate movement was clumsy, especially the right side. He cannot perform the heel-knee-tibia test, the Romberg's sign was a mild 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, nourish nerves, regulate his immune system and improve blood circulation. This was combined with rehabilitation training.     

After 14 days treatment the patient's sleep was much better, he slept less than before, he felt more energetic and he now spoke better. There was less static tremor, he could walk better and his movement endurance was much better.  His blood oxygen saturation was between 95% and 97%.


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