Bautista - Leukodystrophy (Uruguay) Update on July 29, 2015

The second round treatment:

Name: Bautista Alberdi Garcia
Sex: Male
Country: Uruguay
Age: 5 years
Diagnosis: 1. Leukodystrophy 2. Epilepsy 3. Slight Anemia
Date: June 23th, 2015
Days Admitted to Hospital: 22 days

Before treatment:  
The patient was born on Sept. 17th, 2015 through C-section. The operation was good and the patient was normal. His weight was 2.85kg.  When he was 13 months old, it was found that his motor function and intelligence were bad compared to other children of the same age. He could walk with other’s help. His muscle tension goes high when he cries. The power for neck and upper limbs’ movement were bad. He couldn’t say “papa” or “mama”. He was taken to a local hospital and was undiagnosed there. He received clonazepam to treat the high muscle tension of lower limbs. After that, the patient’s muscle tension was close to normal. He could say simple words like “papa”, “mama”, but his motor function was worse, he couldn’t walk at all. At the age of 34 months, he went to Cuba and had MRI, he was diagnosed as leukodystrophy and had rehabilitation exercise, but there was less effect. The motor function of lower limbs was totally controlled. His left hand could grasp. His upper limbs could be lifted or moved away from bed for 5 cm. His neck could hardly hold his head. He couldn’t turn over or sit-up, he could only say “ya” and communicate with others in simple words, but his intelligence was worse. He came to our center to have a treatment 2 years ago. After our treatment, he could eat more. His nystagmus was less. The muscle power of neck and back were better. He could sit-up by himself for 3-4 minutes, and he could cross his legs. When he sat, his head was straighter and his grip was better. The upper limbs’ muscle power was better, he could raise his hands over his head, and the movement of both upper limbs was better. He could holds up his body with both upper limbs in prone position. He could bend his knees and hold up his body with both lower limbs. The muscle power of four limbs was lower than before, his lower limbs could do passive activity easier. These improvements achieved and maintained for about 2 years. His condition became worse in half a year ago. He had continuous onsets epilepsy. The disease attacked every day or alternate days. He couldn’t speak or swallow, he couldn’t turn over or raise his head. The movement of four limbs was weaker, his family wanted a better life, so he came to our medical center.

His spirit was bad, his sleep was good. He was fed through his stomach. His urination and defecation were normal.

Admission PE:
Bp: 82/56mmHg. Hr: 112/min. Height: 100cm. Weight: 11.5kgs. His nutrition was bad. There was no yellow stains or petechia on skin and mucosa. The pharynx was not congested. The respiratory sounds in both lungs were clear, with no dry or moist rales. The heart sound was strong. The heart rate was faster than normal. The cardiac rhythm was irregular, with no obvious murmur in the valves. The abdomen was flat, with no pressing pain or rebound tenderness. The liver and spleen were normal. The inferior border of costal arch was bulge, the spinal was bent to left. He had slight anemia, it was microcytic hypochromic anemia. 

Nervous System Examination:
Bautista Alberdi Garcia was always sleepy. He could only say “ah”. His comprehension was bad. He could not cooperate with the orientation, memory and judgment examination. Both pupils were equal in size and round, the diameter was 4.0mm. Right pupils was insensitive to light stimulus. The eyeballs movement was clumsy. The forehead wrinkle pattern was symmetrical. The nasolabial sulcus was equal in depth. He used nasogastric tube to eat and he couldn’t swallow. He couldn’t cooperate with other neurological examination. His neck and back were weak. He couldn’t raise his head even with someone’s help. He couldn’t turn over or sit-up. The muscle power of both upper limbs was at level 2, both lower limbs was at level 1. Both feet were inverse deformed, left foot bent 90 degrees, right foot bent 110 degrees. His motor function was poor, he couldn’t keep sitting. The muscle tension of four limbs was normal. The tender reflex of lower limbs was weak. The abdominal reflex was normal. Bilateral Hoffmann sign, Babinski sign and sucking reflex were negative. Bilateral palm jaw reflex was positive. He couldn’t cooperate with sensing system and coordinate movement examination. The meningeal irritation sign was negative.

Treatment:
After admission, the patient was diagnosed as leukodystrophy, epilepsy and microcytic hypochromic anemia. He received treatment to fix the abnormal nerves and regenerate new normal nerves. He was injected with stem cells and mesenchymal stem cells to correct anemia, improve the blood circulation and immunity, nourish the neurons and neurological rehabilitation.

Post-treatment:
The patient was chocked with water when he was being bathed, and he had a fever. He had epileptic attacked for 20 minutes. After treatment, his condition was better, he had less epilepsy, the seizure occured every 3-5 days, and it lasted 20 seconds. His back had more power. He could swallow. He could say more words. The movement was more. His muscle power was better, the right upper limb’s muscle was at level 3, and the left one was at level 2+. His right hand could hold objects. The muscle power of both lower limbs was at level 2.

The first round treatment:

Name: Bautista Alberdi Garcia         
Sex: Male
Country: Uruguay
Age: 2 years and 9 months
Diagnoses: 1. Leukodystrophy 2. upper respiratory tract infection 3. microcytic hypochromic anemia 4. Dysfunction of liver
Admission Date: August 23, 2012
Days Admitted to Hospital: 26

Before treatment:
The patient was delivered full-term by cesarean section on September 17, 2009. The operation was successful. The baby was normal at the birth. The weight: 2.85kg. His parents found the patient's motor ability and intelligence was obviously lagging behind the normal baby when he was 13 months. With some assistance, the patient could walk. The muscle tone of both lower limbs was high when he cries and screams. He had poor muscle to support his head. The motor ability of both upper limbs was poor. He was unable to say "daddy" "mama" and so on. He was sent to the local hospital, but didn't receive a definite diagnosis. The patient was given clonazepam for temporary relieve of the muscle tone of both lower limbs. Then the incidents of hypermyotonia were further reduced than before. The patient was able to say simple words, such as "daddy" "mama", when he was 2 years. But the motor function was obviously slowed down. He was completely unable to walk. The patient was taken to Cuba for therapy when he was 2 years and 10 months. The MRI of head showed: leukodystrophy. And he was diagnosed with Leukodystrophy. The patient received rehabilitation training. But the effect was not good. At admission, the patient's motor function was completely limited. His left hand could grasp. Both upper limbs could only lift off the surface 5cm. The muscle strength to support head was weak. He couldn't turn over or sit up. He only could say "e-ye". The patient had simple communication with others. The intelligence level was obviously below normal.

Nervous System Examination:
Bautista Alberdi Garcia was alert. Asyndesis, could only say "e-ya". He couldn��t cooperate with the examination of orientation or memory. His comprehensive ability was obviously poor. He only could communicate with parents by using sounds and gestures. Both pupils were equal in size and round, their diameter was 3.0mms. Both pupils had slow reaction to light stimulus. Both eyeballs had no flexible movement. His eyes had obvious horizontal nystagmus. The forehead wrinkle pattern was symmetrical. The bilateral nasolabial sulcus was equal in depth. He couldn't cooperate with the examination of other cranial nerves. He had movement disturbance of the four limbs and trunk. The muscle strength of his back and waist was weak. Without some assistance, the patient couldn't raise his head, turn over or sit up. The grip strength of both hands was weak. He could only lift his upper limbs off the bed surface. But he couldn't raise arms above his head. Both upper limbs were unable to finish wide margin adduction or abduction. He couldn't support himself with both hands in clinostatism. The motor function of both lower limbs was completely limited. The muscle tone of four limbs was higher than normal. Both lower limbs had movement difficulty for the higher muscle tone of both lower limbs. The tendon reflexes of all four limbs were weakened. Bilateral abdominal reflexes were normal. Bilateral Hoffmann's sign and bilateral sucking reflex were negative. Bilateral palm jaw reflex was negative. The jaw reflex was negative. Bilateral Babinski sign was positive. The patient couldn't cooperate with the examination of sensory system. He also couldn't cooperate with coordinate movement examination. There were no signs of meningeal irritation.

Treatment: 
We initially gave Bautista Alberdi Garcia a complete examination, and he was diagnosed with 1. Leukodystrophy 2. upper respiratory tract infection 3. microcytic hypochromic anemia 4. Dysfunction of liver. He received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and to nourish the neurons. He also received treatment to protect liver function, correction of anemia. This was combined with antibiotics for anti-infection and daily physical rehabilitation training to improve the movement function of limbs.

Post treatment:
The upper respiratory tract infection has been cured. The microcytic hypochromic anemia has taken a turn for the better. The liver function was almost normal. His appetite is much better than before. The horizontal nystagmus was reduced more than before. The muscle strength of the neck and back are stronger than before. With legs crossed, he can maintain a sitting position 3-4 minutes without assistance. The head is much straighter in the sitting position. The hold power of both hands is stronger than before. The muscle strength of both upper limbs is improved. He can lift hands above his head. The movement range of upper limbs has increased much more than before. Both upper limbs can support him for several seconds in a prone position and he can bend knees for support. The muscle tone of four limbs is obviously reduced. It is much easier for his lower limbs to have passive activity.

Bautista's family member take photoes with our doctors.

E-mail:

Date: 2015-7-21

Hello dra like this, I wanted to let you know we got to Uruguay, the trip was quiet for Bautista.
We gave the medication properly, we only had to give montmorillonite powder when it hurt his stomach, and a quarter of clonazepam when noticing very restless.
Since this home is pretty good, without epilepsy, there are times when one is awake that pulls her head back as when I was there.
We are putting emphasis on nutrition and sent 15 days analysis.
From already very grateful for everything.

Best regards.

Magela (breast Baptist)