AMMAR-Muscular dystrophy(Philippines) Post on April 2, 2011

Sex: Male
Country: Philippines
Age: 21
Diagnoses: 1.Muscular dystrophy 2. Fatty liver (mild)
Admission Date: 2011-03-31
Days Admitted to the Hospital: 35

Ammar started losing his balance and would frequently fall when he was 4 years old without an obvious cause. When he walked he would vacillate to the left and to the right. He also had difficulty with walking upstairs and standing up from a squatting position. Before standing up he would have to switch from a prone position to a supine position, and then use both hands to steady himself and try to stand up. He had a positive Gower's sign. An EMG examination was given at the local hospital and DMD was considered. Genetic testing was suggested but Ammar did not have the testing done. The symptoms soon started to progress gradually. There was atrophy in the muscles of all four limbs and the muscles of the pelvic girdle. Ammar was involved in a car accident 10 years ago and couldn't walk after that. He had to rely on a wheelchair to get around. At present, the arms cannot be raised and the hip extensor muscles cannot be stretched straight out.

When Ammar was admitted to our medical center he was in good spirits and was getting a good amount of sleep. The muscle strength of the shoulders was weak and swiveling and shrugging was difficult. There was atrophy in the bilateral deltoid, biceps, triceps, forearm muscles, iliopsoas, quadriceps femoris, and gastrocnemius muscle. The calf muscles were enlarged and hard. The superficial sensation and proprioceptive sensation was normal. Ammar was able to complete the digital opposition test and the rapid rotation test but was unable to finish the finger to nose test or the Heel-knee-shin test.

The EMG showed: myocardiogenic damage. According to Ammar's medical history, symptoms, physical signs and assistant examination, a diagnosis of DMD was considered.

After the completion of the stem cell treatment and physical rehabilitation therapy, the muscle strength of all four limbs had increased, the muscle strength of both upper limbs'  proximal-end was increased to level 2, and the distal-end was increased to level 3. The muscle strength of both lower limbs' distal-end was increased to level 3. Both forearms can now be stretched straight out and Ammar can grasp items for 10 times while the forearms are in the horizontal position. During the physical rehabilitation training, the range of motion of the pelvis and knee joints was increased. The enlarged calf muscles are not as hard as they were before.


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