Mr. Aron-Hereditary Inclusion Body Myopathy-(Israel)

Name: Mr. Aron
Sex: Male
Nationality: Israeli
Age: 46Y
Diagnosis: HIBM (hereditary inclusion body myopathy)

Before treatment: 
The patient had foot drop 17 years ago and his walking was affected. A couple months later his left leg became weak, it was hard for him to raise his legs and his arms also became weak later. He was diagnosed with HIBM 16 years ago and he did rehabilitation training. At present he uses a brace for walking, he needs help with going up and down stairs, he is able to get up from bed, can sit up and turn his body over himself. He has the basic ability to care for  himself.
His spirit is good, his diet , sleep and urination are normal. He defecates  once a day with medicinal help.

Admission PE:
Bp: 131/87mmHg, Hr: 67/min, breathing rate: 18/min, body temperature: 36 degrees. Height 179cm, weight 73Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of his skin and mucosa, no tonsil swelling, the chest development is normal and the breathing sounds of both lungs were clear with no obvious dry or moist rales. The heart beat is powerful with regular cardiac rhythm and with no obvious murmur in the valves. The abdomen was flat and soft with no masses or tenderness, the liver and spleen were normal by touch, shifting dullness was negative, the spinal column was normal. There was mild edema of the left ankle joint.

Nervous System Examination:
Patient was alert, mental status was fine and speech was clear. His memory,  orientation and calculation abilities were normal. Both pupils were equal in size, round, diameter of 3 mm, react well to light and the eyeballs can move freely. Bilateral forehead wrinkle and nasolabial fold are symmetrical. He could close his eyes powerfully, show teeth as normal, bulge cheeks without air leakage and the bilateral soft palate could lift as normal. He could turn his head and shrug powerfully. Muscle power of the arms proximal side was 4- degrees,  distal side was 4 degrees. Muscle power of the right leg was 4 degrees, the left leg was 3 degrees and the muscle tone of the 4 limbs was normal. The tendon reflex of the arms was reduced and of the legs was normal. The abdominal reflex could not be induced by examination. The bilateral palm-jaw reflex was negative, the Hoffmann sign and Rossilimo sign of both sides were negative, the bilateral Babinski sign was negative. His sensory system was normal by gross examination, finger opposite movement was normal, he could not perform the finger to nose test, fast alternate movement, and heel-knee-tibia test well. The meningeal irritation sign was negative.

Treatment:
After the admission he undertook related examinations and received 3 times cells regeneration treatment to repair his damaged muscle cells, replace dead cells, nourish cells, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 15 days treatment the muscle power of his arms increased. The proximal side muscle power was 4 degrees, distal side was 4+ degrees. The movement ability and strength of the foot joints improved. He could stand  from a sitting position with much more flexibility. His back and waist muscle power increased.

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