Naufal Danang-Hereditary Progressive Muscular Dystrophy-(Indonesia)-Posted on August 31th, 2016

Name: Naufal Danang
Sex: Male
Nationality: Indonesian
Age: 15
Diagnosis: Hereditary Progressive Muscular Dystrophy
Date of Admission: July 8th, 2016
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
When Naufal was 4 years old, he began to regularly not feel well without a known cause. His parents weren’t too concerned about the situation at the time, but soon after that, Naufal began to have trouble with walking, his legs became weaker, it was difficult for him to walk up stairs so his parents took him to the hospital one and half years later and he was diagnosed with Progressive Muscular Dystrophy. He took vitamins and did rehabilitation training, but his condition did not improve. When he was 6 years old, he was unable to sit up from a lying position. The muscle power in his arms and legs was weak. He was sometimes unable to take care of himself.  Naufal was brought to our hospital 2 years ago and after treatment he felt stronger and he didn’t fall down as much. The muscle power in the proximal end of the arms was reduced recently this year and he fell a little more frequently than before. His cognitive ability, language skills and mental condition deteriorated, so he came to our hospital again and was diagnosed with muscular dystrophy.
Naufal was in good spirits. He was a picky eater. He didn’t like vegetables or fruits. He slept well. He had bowel movements once every day or two. His feces was dry. His mental condition was unstable. His weight was normal.

Admission PE:
Bp: 125/74mmHg; Hr: 85/min. Temperature: 36.6 degrees. Height: 172cms, weight: 66Kgs. Naufal’s walking posture was a little abnormal. His shoulders drooped.. There were no yellow stains or petechia on the skin and mucous. The respiration of both lungs was clear. There were no dry or moist rales. The rhythm of his heartbeat was normal with no obvious murmur in the valves. His abdomen was a little distended and soft with no pressing pain or rebound tenderness. The liver and spleen were normal. He had mild muscular atrophy in the shoulder girdle, supraspinatus muscle, infraspinous muscle, biceps brachii, triceps brachii, thenar muscles and pelvic girdle muscle. He walked slowly, his stamina was low. He was able to stand in a stable manner.

Nervous System Examination:
Naufal Danang was alert but he was in a bad mood. His speech was clear but he didn’t speak very much. His memory, calculation ability and orientation were bad. Both pupils were equal in size and round, the diameter was 3 mms, both eyes had sensitive responses to light stimuli. Both eyeballs could move freely. He had horizontal nystagmus. When he read, he felt dizzy and he was not able to see objects clearly. The nasolabial fold and forehead wrinkle pattern were symmetrical. He could close his eyes strongly. The tongue was centered in the oral cavity. There was no teeth deflection. When he expanded his cheeks, there was no leakage of air.. He was able to raise his soft palate powerfully. The proximal end adductor muscle power of both upper limbs was at level 4-, the abductor muscle power was at level 3-, the distal end muscle power was at level 3. The gripping strength was at level 5-. The muscle power of the left lower limb was at level 3+, the right lower limb was at level 4-. The muscle tension of all four limbs was a little lower than normal. The tendon reflex of both upper limbs was normal. The tendon reflex of both lower limbs was a little weaker. The bilateral abdominal reflexes were normal. The bilateral Babinski sign was positive. The bilateral deep sensation, superficial sensation and epicritic sensation were normal. He was able to do the finger-to-finger test, finger-to-nose test and rapid rotation test. The heel-knee-tibia test was done slowly. The meningeal irritation sign was negative.

Treatment:
After admission, Naufal was diagnosed with progressive muscular dystrophy. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged muscle cells, regenerate new cells, activate the stem cells in his body, improve his blood circulation, regulate his immune system, nourish muscle cells and repair his damaged muscle tissues. We also gave him daily physical and language rehabilitation.   

Post-treatment:
After 14 days of treatment, Naufal' s eating habits and mood improved. He spoke more words. His short-term memory was better. His muscle power and stamina improved. The adductor muscle power was at level 4, the abductor muscle power was at level 3, the distal end muscle power was at level 3+. The gripping strength was at level 5-. The muscle power of the lower limbs was at level 4.