Levy Shoshana Ayala-Parkinson Disease-(Israel)

Name: Levy Shoshana Ayala 
Sex: Female
Nationality: Israeli
Age: 72Y
Diagnosis: 1. Parkinson Disease 2. Hypertension

Before treatment:
The patient felt tremor in her arms 7 years ago. Her condition got worse day by day and she moved slowly so she went to a local hospital and was diagnosed with Parkinson's disease. 2 years later it was hard for her to walk and someone took care of her. At present she has tremor, stiffness in her muscles, slow movement, finds it hard to walk and she also has tongue muscle tremor. It is hard for her to write and her balance function is poor.
Her sleep and diet are good. Her urination and defecation functions are good. She has had hypertension for many years.

Admission PE:
Bp: 127/78mmHg, Hr: 80/min. Breathing rate: 19/min. The nutrition status was fine, there is no broken or bleeding spots of her skin and mucosa, no lymph nodes swollen and no tonsil swelling. 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 with no tenderness or rebound tenderness and no masses. Liver and spleen were in the normal position by touch, shifting dullness was negative, there was pitting edema of her legs.

Nervous System Examination:
Patient was alert, slow in her speech and her voice was low and weak. Her orientation, cognitive function and calculation abilities were normal. Both pupils were equal and round, diameter of 3.0 mm, react well to light and the eyeballs can move freely with no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, she could extend her tongue out but with tongue muscle tremor. Bilateral soft palate could lift powerfully and the uvula was normal. There was slow movement with static tremor in the 4 limbs, especially her right arm. The 4 limbs muscle power was 4 degrees, there were difficulties when she wanted to roll over in bed or get up and she had difficulty to stand independently. When her condition was good she could walk a short distance slowly. The muscle tone of the arms was normal, the leg muscle tone was slightly lower than normal. Her bilateral biceps reflex, triceps reflex and radial periosteal reflex were normal. The Achilles tendon reflex and patellar tendon reflex were reduced, bilateral Hoffmann sign was negative, the Rossilimo sign of both sides were positive, sucking reflex was negative. The palm-jaw reflex was positive, Babinski sign of both sides were negative, her sensory system examinations were normal. Her finger to nose and finger opposite movement tests were not stable, especially the right side. The bilateral fast alternate movements were clumsy, heel-knee-tibia test was clumsy, the Romberg's sign was positive. She displayed a tendency to fall backward, the meningeal irritation sign was negative.

After the admission she received related examinations and received 3 times nerve regeneration treatment to repair her damaged nerves, replace dead nerves, nourish nerves, regulate her immune system and improve blood circulation. This was done with rehabilitation training.     

After 14 days treatment she spoke clearer and louder, her facial expression was much more natural, the limbs could move with much more flexibility and the slow movement alleviated obviously. Her muscle power increased to 5- degrees, the right arm static tremor reduced, her trunk stiffness was also relieved and she could walk with a much better gait. She could perform the coordinate movement and fast alternate movement, finger opposite movement was  much more flexible. Her balance improved.

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