Tatyana Malenkova-Spinocerebellar ataxia (Russia) Posted on September 18, 2014

Name: Tatyana Malenkova 
Sex: Female
Age:33 years
Diagnosis:Spinocerebellar ataxia
Date: August 22, 2014
Days Admitted to Hospital: 29 days

Before treatment:
            The patient suffered from gait abnormalities and walking instability, 3 years ago without obvious incentive. These symptoms progressed gradually and aggravated gradually. He suffered from weakness of her four limbs. The patient suffered from speech disorders and swallowing difficulty, 1 year ago. She went to a local hospital and received gene test in local hospital. She was diagnosed with spinocerebellar ataxia, Type 1. At present, the patient's lower limbs suffered from balance disorders, walking gait abnormal. The distance between both feet was wider than normal when she walked. She shakes when she turns. She couldn't stand with single leg. She could take care of herself in most her life.

            From the onset of disease, the patient's spirit was good. Her diet and sleep were almost normal. Her urine and defecation were almost normal. The patient's mother, uncle, aunt and cousin had the same disease. There was no other genetic disease.

Admission PE:
            Bp: 130/88mmHg; Hr: 117/min, temperature: 37 deg. Height: 164cm, weight:  51.5Kg. The nutrition was normal. The skin and mucosa were intact, with no yellow stains or petechia. Thorax was symmetrical. The breath sounds in both lungs were clear, with no dry or moist rales. There was no pleural fricative. Through auscultation, we discovered that the heart sounds were strong, with no pathological murmur in auscultation area of each valve. The rhythm of heart was regular, Hr:117/min. The abdomen was flat and soft, with no masses. The borborygmus was 4-5 times each minute. The liver and spleen were not touched under the rib. The abdomen was flat and soft. There was no edema in either of the lower limbs.

Nervous System Examination:
            Tatyana Malenkova was alert. Her speech was not clear as before. Her speech was slower sometimes. Her memory, calculation ability and orientation were almost normal. Both pupils were equal in size and round, the diameter was 3.0mm. Both eyeballs could move freely and flexibly and the pupils were sensitive to light stimulus. There was no obvious nystagmus. The vision and visual field were normal. There was diplopia when the patient stares to left side or right side. The distance of seeing things in pairs was 10 cm. The forehead wrinkle pattern was symmetrical. The bilateral nasolabial sulcus was equal in depth. The chewing ability of both sides was symmetrical and strong. The tongue was centered in the oral cavity and the teeth were shown without deflection. She could raise the soft palate normally. The uvula was in the center of oral cavity. The hearing ability was normal. She could shrug her shoulders and turn head with strong and symmetrical muscles. The muscle strength of both her upper limbs was at level 5. The muscle strength of both lower limbs was at level 4+. The muscle tone of her four limbs was almost normal. Bilateral tendon reflex were normal. Bilateral patellar tendon reflex was active. The abdominal reflexes were normal. Bilateral sucking reflex was negative. Left side Hoffmann sign was positive. Left side Rossilimo sign was positive. Bilateral palm jaw reflex was positive. Bilateral Babinski sign was positive. The deep and shallow sensation of both upper limbs and face were normal. The deep and shallow sensation of trunk and lower limbs was slow down. Both sides completed the finger-nose test in a slight unstable manner. She did the rapid rotation test normally. She did the heel-knee test in an unstable manner. If she closes eyes and we push her, she finds it difficult to maintain balance. She was unable to stand with single leg. The distance between two feet was wider than when she walks. She was unable to walk straight. She shook her body when she makes a turn.

            We initially gave the patient a complete examination and she was diagnosed with spinocerebellar ataxia. The patient received treatment for nerve regeneration and to activate stem cells in vivo. She also received treatment to improve the blood circulation to increase the blood supply to the damaged neurons, nourish neurons and neural cells repair. We also gave her rehabilitation training.

            The patient's condition has obvious improvement. The distance of seeing things in pairs has reduced to 2cm when her eyes stare to left side or right side. She does the rapid rotation test and finger-to-nose test in a more flexible manner. She does the heel-knee test in a more stable manner. The positive index of Romberg sign has changed to negative. She can stand with single leg for 10-15 seconds and walks straight better. She can run a short-range.



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