Nazarov Vidadi-Cerebellar ataxia-(Azerbaijan)-Post on February 15, 2012

Name: Nazarov Vidadi                      
Sex: Male
Country: Azerbaijan
Age: 35
Diagnoses: Cerebellar ataxia, cerebellar atrophy
Admission Date: 2011-12-24
Days Admitted to Hospital: 28

Medical History:
About 5 years ago Nazarov developed back pain as well as occasional loss of vision. He was easily agitated. There was also a gradual balance disorder with the legs causing Nazarov to lean to the right side. His walking posture was abnormal and he had difficulty with activities like writing, buttoning his shirt, combing his hair, etc. because of problems with the fine motor skills. Three years ago, he developed a lisp, would often choke while drinking liquids and would lose his balance and fall easily. These symptoms continued to progress including slurred speech and slow reactions. Nazarov needs to use crutches and can only walk a distance of 10 meters. There is obvious dizziness when he tries to switch body positions.

Nervous System Examination:
Nazarov Vidadi was alert, but his speech was slowly. His memory, calculation ability and orientation were almost normal. Both pupils were equal in size and round, the diameter was 3.0mms. The pupils were sensitive to light stimulus. There was horizontal and vertical nystagmus. The vision and visual field were normal. The forehead wrinkle pattern was symmetrical. The chewing was symmetrical and the chewing ability was strong. The bilateral nasolabial sulcus was equal in depth. The tongue was centered in the oral cavity and the teeth were shown without deflection. The muscle strength of all four limbs was level 5; The bilateral biceps reflex, triceps reflex, radial periosteal reflex, patellar tendon reflex, and ankle tendon reflex were normal. The abdominal reflexes were normal. The bilateral sucking reflex was negative. The bilateral Hoffmann's sign was negative. The bilateral Babinski's sign was neutral. The deep sensation and shallow sensation was normal. The bilateral finger-to-nose test and rapid rotation test were positive. The Heel-knee-shin test of both legs was not stable. The Romberg's sign was positive.

Treatment:
We initially gave Nazarov Vidadi a complete examination and he was diagnosed with cerebellar ataxia and cerebellar atrophy. Then we proceeded with giving him nutritional treatment for the neurons. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged neurons. We also gave him daily physical rehabilitation training.

Post-treatment:
The nystagmus has been reduced and the vertical nystagmus has been completely alleviated. The balancing ability while in the standing position is better than before. There is better control over his balance when both feet are 15cms apart. The Romberg's sign is not as severe as before. He can now finish the bilateral finger-to-nose-test, rapid rotation test and Heel-knee-shin test in a more stable manner. Both hands can pinch small items in a more stable manner. The steppage gait on the right side is not as severe as before. The gait on the left side is the same as before.