Makedonaka Perkovic-Limb-girdle Muscular Dystrophy-(Macedonia)

Name: Makedonaka Perkovic
Sex: Female
Nationality: Macedonian
Age: 49Y
Diagnosis: 1. Limb-girdle Muscular Dystrophy(LGMD)2. Hypertension
Discharge Date: 2017/11/27

Before treatment:
The patient felt weak in her legs 12 years ago. It was hard  to climb stairs so she went to a local hospital and did an EMG test. She was prescribed prednisone 20mg/w for 1 month but her condition got worse day by day. 2 years ago the muscle power of her back and waist decreased and it was easy for her to get tired in the back and shoulders. She did a gene test and was diagnosed with LGMB. Her condition got worse quickly in the past year and it was hard for her to walk. For now, she is able to take care of herself but she feels weak in the limbs and needs some help with walking. She feels less powerful in her shoulders and waist.
Her spirit is good, her diet and sleep are normal. Her urination and defecation functions are normal.

Admission PE:
Bp: 143/93mmHg, Hr: 75/min, body temperature: 36.0 degrees, height: 170cm, weight: 58Kg. Nutrition status is normal with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht. Chest development is normal, the respiratory sounds in both lungs were clear with no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was soft, with no masses or tenderness.  Her liver and spleen were normal. The spinal column is normal with no edema of the legs.

Nervous System Examination:
Patient was alert with a good mental status and clear speech. Her memory,  orientation and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3mm, react well to light, the eyeballs can move freely and there was no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, she can close her eyes powerfully and her tongue is in middle with no tongue muscle atrophy. Showing teeth is normal, she can bulge her cheeks as normal, bilateral soft plate can lift as normal, the neck can turn and she can shrug powerfully. The hands grip force were 5 degrees, left arm proximal side muscle power was 4 degrees, right arm proximal side muscle power was 4+ degrees, the  distal side muscle power of the arms were 5- degrees. Muscle power of the legs were 3 degrees. The 4 limbs muscle tone were normal. Biceps reflex of the arms was normal, the arm radial periosteal reflex, leg patellar tendon reflex and ankle reflex can not be induced,. Bilateral palm-jaw reflex, Hoffmann sign, Rossilimo sign and Babinski sign were all negative. The finger to nose test, fast alternate movement and bilateral Heel-knee-tibia test were basically normal. Right hand little finger can not complete the finger opposite test well, the others were normal. The meningeal irritation sign was negative.

After the admission she received 3  cell regeneration treatments (neural stem cells and mesenchymal stem cells) to repair her  damaged muscle cells, replace dead cells with new injected stem cells, nourish muscle cells, regulate her immune system and improve blood circulation. This was done with rehabilitation training.     

After 14 days treatment she felt the fatigue had reduced, right hand little finger opposite movement got better, the left arm proximal side muscle power increased to around 4+ degrees. She could now raise her arms easier and her shoulder was more flexible. The leg muscle power increased 10% and now  is around 3+ degrees. She can climb up stairs much easier and faster than before and she walked better than before.

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