Fredrick Tugume-Cerebellar Ataxia-(Uganda)-Update on May 24th, 2016

The second round treatment:

Name: Fredrick Tugume                
Sex: Male
Country: Uganda
Age:38
Diagnosis: Cerebellar Ataxia
Date of Admission: Jan.31, 2016
Treatment hospital/period: Wu Medical Center/12 days

Before treatment:
The patient’s battle companion found he had balance disturbance 3 years ago. He had abnormal gait, he walked like a drunkard, and sometimes he falls. Head MRI: cerebellar atrophy. Diagnosed as Cerebellar Ataxia. He had worse balance disturbance. He had language problems 2 and half years ago. It was cerebellar language. He chocked 1 year ago, so he went to our center to have the stem cells treatment, after the treatment, his balance was better, 50% of his motor function was better. Now he has abnormal gait, he could not stand on one foot very well. He could take care of himself. He wants to have a better treatment, so he came to our hospital.

He was in good spirit. His eating, urination and excrement were good.

Admission PE:
Bp: 124/84mmHg; Hr: 73/min, Temperature: 36.4. Br: 18/min, Height: 183cms, weight: 83kg. He was in good nutrition. The skin and mucosa were normal with no yellow stains or petechia. The thorax was symmetrical. The respiratory sounds in both lungs were clear, with no dry or moist rales. There was no spirant of pleura. The heart sound was strong. The cardiac rhythm was regular, with no obvious murmur in the valves. The abdomen was flat and soft, the liver and spleen were normal. There was no edema in both lower limbs.

Nervous System Examination:
Fredrick Tugume was alert. His speech was clear, mild cerebellar language, his memory, calculation and coordination were normal. Both pupils were equal in size and round, the diameter was 3.0mm. Both pupils were sensitive to light stimulus. His sight and vision field were normal. There was discontinued slight nystagmus when he looked to left. The forehead wrinkle pattern was symmetrical. Both side chew muscles were symmetrical and powerful. The nasolabial sulcus was equal in depth. There was no teeth deflection. He could raise the soft palate strongly. The uvula was in the center. Cheek blowing was normal. The tongue was centered in the oral cavity. His sound was normal. He could turn neck and shrug his shoulders strongly. The muscle power of four limbs was at level 5. The muscle tension of four limbs was normal. He had drunken-type gait. Both side ankle reflex was weak. Left abdominal reflexes was normal, right side abdominal reflexes was weak. Both side pathological sign was negative. The deep and shallow sensation was normal. Both side finger-to-finger test and rapid rotation test were normal. Both side finger-to-nose test and heel-knee-tibia test were normal. The rombergs sign was positive. He was easy to lean to right side. He couldn’t stand on one foot or walk straight. The meningeal irritation sign was negative. Brain MRI: cerebellar atrophy.

Treatment:
After admission, Fredrick Tugume received the relevant examinations and diagnosed as spinocebellar ataxia. So he received 3 times of neural stem cell injection and 3 times of mesenchymal stem cell injection to improve the blood circulation, nourish the neurons and rehabilitation training.

Post-treatment:
After 12 days treatment, he didn’t have nystagmus. The rombergs sign was negative. He could stand on left feet for more than 20 second, right feet for 10 seconds. He could stand better and walk more straight.

The first round treatment:

Name: Fredrick Tugume                
Sex: Male
Country: Uganda
Age: 37 years
Diagnosis: Cerebellar Ataxia
Date: Feb. 14th, 2015
Days Admitted to Hospital: 22 days

Before treatment:
He was found to have balance disturbance 2 years ago. He had abnormal gait, he walked like a drunkard, and sometimes he falls.
Head MRI: cerebellar atrophy. Diagnosis was undetermined and untreated.
He had worse balance disturbance. He had language problems 1 and half years ago. It was cerebellar language. He chocked 1 year ago, so he went to a hospital again and again but the diagnosis was still undetermined and untreated. He has abnormal gait, he could not stand on one foot. He could take care of himself most of time. He wants to have a better treatment, so he came to our hospital.

He was in good spirit. His eating, urination and excrement were good. He slept 3-4 hours per day.

Admission PE:
Bp: 110/70mmHg; Hr: 75/min, Temperature: 36.0. Height: 182cms, weight: 67kgs. He was in good nutrition. The skin and mucosa were normal with no yellow stains or petechia. The thorax was symmetrical. The respiratory sounds in both lungs were clear, with no dry or moist rales. The heart sound was strong. The cardiac rhythm was regular, with no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. The borborygmus: 4-5/min. The liver and spleen were normal. There was no edema in both lower limbs.

Nervous System Examination:
Fredrick Tugume was alert. His cerebellar language, memory, calculation and coordination were normal. Both pupils were equal in size and round, the diameter was 3.0mm. Both pupils were sensitive to light stimulus. His sight and vision field were normal. There was slight nystagmus when he looked to left. The forehead wrinkle pattern was symmetrical. Masticators of both sides were symmetrical and powerful. The nasolabial sulcus was equal in depth. There was no teeth deflection. He could raise the soft palate strongly. The uvula was leant to the left. Cheek blowing was normal. The tongue was centred in the oral cavity. His sound was normal. He could turn neck and shrug his shoulders strongly. The muscle power of four limbs was at level 5. The muscle tension of four limbs was normal. He had drunken-type gait. Both side tendon reflexes of biceps brachii and triceps brachii, radial periosteal reflex, ankle reflex, left lower abdominal reflexes and right side abdominal reflexes disappeared. Right side patella tendon reflex and left side upper and middle abdominal reflexes were normal. Bilateral Hoffmann sign, sucking reflex and Bilateral Babinski sign were negative. The deep and shallow sensation was normal. Both side finger-to-finger test and rapid rotation test were clumsily done. Both side finger-to-nose test and heel-knee-tibia test were not done stably or exactly. The rombergs sign was positive when he opened or closed his eyes. He couldn’t stand on one foot or walk straight. The meningeal irritation sign was negative. Accessory examination: Brain MRI: cerebellar atrophy.

Treatment:
After admission, Fredrick Tugume received the relevant examinations and was diagnosed as spinocebellar ataxia. The patient received treatment to improve blood circulation, nourish the neurons and this was accompanied with neurological rehabilitation.

Post-treatment:
After treatment, his equilibrium sense was better, the finger-to-finger test and rapid rotation test were faster. Both side finger-to-nose test and heel-knee-tibia test were better than before. The rombergs sign was not obvious. He could stand on one foot for 20 second. He could walk more straightly.

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E-mail:

Date:2015-5-11

Hullo there,
Please find my Lab report sent by Nakasero Hospital Ltd. (NHL).
The physical signs have improved, the finger to finger sign is perfect, the finger to nose sign is also very good but the walking is the one still not okay.
The walking partner is INTERMITTENT meaning it is on and off. some days i am  perfect other days i  am staggering. But the general condition is promising.
Another question is on the medicine you told me to buy, i bought and i am taking,but how long is the dose?
hopping to hear from you soon,
Best regards, greetings to Lisa.
Fredrick Tugume.

Date:2016-5-24
>
> Hi Lisa?
> i have been in the village and now i am back.next month i will start the tests.
> My condition is promising as i can now stand on one leg for 20 seconds,finger to nose sign is good, but i only get trouble when i am slopping; but walking up hill i am OK.
> I attend gym daily for only 30 minutes.
> Greetings to all,especially Dr. Xi.
> Freddie.