Luana Elizabeth Duarte Moran-Optic Nerve Injury-(Paraguay)

Name: Luana Elizabeth Duarte Moran
Sex: Female
Nationality: Paraguay
Age: 5Y
Diagnosis: 1. Optic Nerve Injury 2. Post-Craniopharyngioma  3. Post-Craniopharyngioma Syndrome
Discharge Date: 2019/10/29

Before treatment:
Two and a half years ago the child's vision gradually decreased in both eyes and a month later she lost her vision completely. She was taken to the local hospital for examination and found to have "craniopharyngioma" and underwent a surgical resection. The visual acuity of the child did not recover after the operation. At present she has no vision in both eyes and has no sense of light.
Her spirit, sleep, urination and defecation functions are all normal.

Admission PE:
Bp: 100/63mmHg, heart rate: 111/min, breathing rate: 25/min, body temperature: 37.1 degrees, height: 94cm; weight: 19.5 kg. The patient has moderate nutrition, no damage or bleeding spots of the skin or mucosa, no cyanosis of the lips, no swelling or congestion of oropharynx, no swelling of tonsils, no swelling or node of thyroid, a symmetrical chest, clear respiratory sound of both lungs, no remarkable dry or moist rales heard and no bulging of the precordia. She had a strong heart sound, regular heart rhythm, no obvious murmur heard in the valves, a flat and soft abdomen, no tenderness or rebound tenderness, no masses, normal liver and spleen, negative shifting dullness, normal spinal curves and no edema of the legs.

Nervous System Examination:
The patient was alert, had clear speech, normal calculation,  memory and orientation abilities. The diameter of the left pupil was 5.0mm ,  4.5mm of the right pupil, there was no light reaction, no light perception of the right eye and little light perception of left eye. We were unable to check her eyesight and nystagmus, there was free eyeball movement. The fundus examination showed; light yellow of bilateral fundus, AV ratio as 2:3, normal color of optic nerve head, unclear macular borders. She had a symmetrical forehead wrinkle and nasolabial fold, symmetrical teeth-showing, tongue in the middle when extended and free neck movement. There was normal muscle tone of the 4 limbs, grade 5 muscle power of the 4 limbs, declined physiological reflex, a negative sucking reflex, palm-jaw reflex,  Hoffmann sign, Rossolimo sign and Babinski sign bilaterally. With normal deep and shallow sensation, normal coordination and a negative meningeal irritation sign.

Treatment:
After the admission she received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair her damaged optic nerves, replace dead nerves, nourish nerves, improve body environment, regulate her immune system and improve blood circulation. This was combined with rehabilitation training.   

Post-treatment:
After 14 days treatment her vision function was better, her right eye got more sensitive to light, she was able to discern big and small objects shadows in bright light, she could  see the mobile phone’s light at the distance of 1 meter and both pupil's light reflexes appeared.

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