Roberto Martinez - Muscular dystrophy (Argentina) Posted on April 11, 2013

Name: Roberto Martinez             
Sex: Male
Country: Argentina
Age: 38
Diagnoses: 1. Muscular dystrophy- Facioscapulohumeral dystrophy, 2. Hyperlipidemia
Admission Date: 2013-03-01
Days Admitted to Hospital: 28 days

Before treatment:
The patient suffered from weakness of abdominal muscles and slight atrophy. He received muscle biopsies in a local hospital and was diagnosed with Muscular dystrophy- Facioscapulohumeral dystrophy. He didn't receive special treatment. Then this damaged his bicipital muscle of arm, triceps muscle of arm, pectoralis major and shoulder girdle. The disease progressed gradually and the weakness of the limbs was aggravated. He could't walk up and down stairs as of 8 years ago and the endurance was obviously reduced. He couldn't stand for a long time. He couldn't sit up from clinostatism independently as of 5 years ago. He couldn't stand up from a sitting position independently as of 2 years ago. Before the treatment, there was muscle atrophy in the four limbs' near-end, scapula muscle, deltoid, clavicle up and down the muscle group. The muscle strength of the four limbs was obviously reduced. Both arms couldn't be raised to shoulder level in when in a sitting position. He still could stand, but the balance of the trunk was poor. He walked slowly and at most could walk 15 meters. He needed crutches and other's support to turn round. He had a poor mood.

Admission PE:
Bp: 122/92mmHg; Hr: 71/min. Weight: 84Kg. The degree of respiratory mobility was ok. The respiratory sounds in both lungs were clear, with no dry or moist rales. Through auscultation it was determined that the heart sounds were strong. The cardiac rhythms were normal, with no obvious murmur. Roberto's abdomen had distention and was soft, with no pressing pain or rebound tenderness. We were unable to touch the liver or spleen. There was muscle atrophy in bilateral supraspinatus, infraspinatus, latissimus dorsi, deltoid, biceps brachii and triceps brachii. The muscle atrophy in deltoid, biceps brachii, triceps brachii were more severe. There was obvious muscle atrophy in bilateral iliopsoas, quadriceps femoris and biceps femoris.

Nervous System Examination:
Roberto Martinez was alert and in good spirits. His speech was clear. His memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3.0mm, with normal reaction to light stimulus. Both eyeballs had flexible movement. The forehead wrinkle pattern was symmetrical. The eye closing 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 raising ability of the soft palate was nomal. The pharyngeal reflex was normal. The muscle strength of the shoulders was weak. The motor range of the shoulder joints was limited. The muscle strength of right upper limb's near-end was level 3 (abduction muscle strength is level 3+). The muscle strength of the left upper limb's near-end was level 3-. The muscle strength of both wrists was level 5. The hold power of both hands was level 5. The muscle strength of the bilateral iliopsoas was weak. The muscle strength of the abdominal muscle was almost level 0. The muscle strength of the right lower limb's near-end was level 3. The muscle strength of the left lower limb's near-end was level 3-. The muscle strength of both lower limbs' far-end was level 2. The muscle tone of the four limbs was almost normal. The tendon reflex of the four limbs was reduced. The abdominal reflexes were normal. Bilateral pathology sign was negative. Bilateral side was able to do the finger to nose test, the digital opposition test and the rapid rotation test was almost normal. The patient was unable to finish the Heel-knee-shin test. There were no signs of meningeal irritation.

Treatment: 
We gave Roberto Martinez a complete examination. We initially give the patient treatment to start muscle fibers repair and muscle fibers regeneration. Then Roberto Martinez received treatment to nourish the neurons, to improve the blood circulation in order to increase the blood supply to the damaged nerves. He also received treatment to promote nerve regeneration, nourish the muscle and control blood fat. This was accompanied with rehabilitation training.

Post- treatment:
Roberto Martinez's condition has improved. He has a better mood. The blood fat level is under better control. Weight is 85Kg and increased 1 Kg. The muscle strength of the four limbs, shoulder girdle and the iliopsoas is better than before. The endurance and muscle volume are better than before. The muscle strength of the right upper limb's near-end is level 4+, the muscle strength of the left upper limb's near-end is level 4. The muscle strength of both upper limbs' far-end is level 5. The hold power of both hands is level 5. The muscle strength of the right lower limb's near-end is level 4 and the far-end is level 2+. The muscle strength of the left lower limb's near-end is level 3 and the far-end is level 2. The patient almost can finish the exercises of lifting the hips in supine position. The patient can walk more than 100 meters independently on level ground.
 

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