Martin Trojek-Huntington Disease (Germany) Posted on May 20th, 2015

Name: Martin Trojek        
Sex: Male
Country: Germany
Age: 46 years
Diagnosis: 1. Huntington Disease 2. Hypothyrosis
Date: Apr. 17th, 2015
Days Admitted to Hospital: 27 days

Before treatment:
The patient couldn’t control his body in 2006 without any reason. The disease got worse, he moved slowly and had balance disturbance. He was diagnosed as Huntington Disease after the gene test, untreated. He moved slowly, had balance disturbance, accompanied with choreic movements of upper limbs and head and it stops during sleeping. He could care for himself sometimes. He had cognitive dysfunction, abnormality in spirit, irritability, aggressive behaviors, dysphagia and dysarthria. He wanted a better treatment so he came to our hospital and was diagnosed as Huntington Disease.

His spirit was good. He easily get irritated. His diet was good. He takes pills to go to sleep. His urination and defecation were normal. His weight was normal.

Admission PE:
Bp: 132/87mmHg; Hr: 89/min. RP: 19/min. His pharyngeal had no congestion, both tonsils were normal. The respiration of both lungs was rough, with no dry or moist rales. His heart rhythm was normal and strong, without obvious murmur in the valves. The abdomen was bulge and soft with no tenderness or rebound tenderness. The liver and spleen were normal, when the doctor percussed it, the abdomen had tympanic sound. His four limbs and spine were normal. There was no dropsy on both lower limbs. T3 was lower than normal.

Nervous System Examination:
Martin Trojek was alert and good in spirit. His reaction was not good. His memory, calculation and orientation abilities were decreased. The diameter of both pupils was 3.0mms, and both pupils were equal in size and round. Both eyeballs could move freely and the pupils reacted normally to light stimulus. There was no nystagmus. The forehead wrinkle pattern was symmetrical. He could close his eyes strongly.  Both nasolabials were equal in depth. The tongue was in the centre of the oral cavity. Both soft palates could be lifted strongly. There was no resistance in the neck. Both upper limbs and head had chorea movements. The muscle power and tension of four limbs were normal. The tendon reflex of four limbs were normal, the depth feeling was normal. The sucking reflex was negative. Both side Hoffmann sign was negative. Both palm jaws reflex was positive. Both side Babinski sign was positive. The finger-nose test, finger-to-finger test and rapid rotation test couldn’t be done. Both lower limbs’ movements were clumsy and rough. Both side heel-knee-tibia test was slowly done. The rombergs sign was positive. The meningeal irritation sign was negative.

Treatment:
Martin Trojek was diagnosed based on the examination as: 1. Huntington Disease 2. Hypothyrosis. He received treatment for nerve nutrition, improvement of blood supply, increasing nerve regeneration, muscle nutrition, controlling his emotion and supplementing of thyroid hormone. We also gave his daily physical rehabilitation.

Post-treatment:
After the treatment, his emotion was stable and calm. There was reduction in his aggressiveness. He could take the drugs and finish the rehabilitation training. His balance was better. The chorea movements of his upper limbs and trunk were less. He could do the finger-nose test, finger to finger test and rapid rotation test slowly. The concordant of lower limbs was better, he could walk better. His treatment was over and discharge is permitted.