Micaela Nahir Favio Forlese-West Syndrome-(Argentina)

Name: Micaela Nahir Favio Forlese 
Sex: Female
Nationality: Argentine
Age: 11Y
Diagnosis: 1. Chronic encephalopathy, West Syndrome  2. Sinus Arrhythmia

Before treatment:
The patient had seizures at the age of 10 months without significant reasons. She was unable to move her right side body so she was taken to the hospital and was diagnosed with "west syndrome, chronic encephalopathy". She was given antiepileptic treatment and her epilepsy was controlled and she went 7 years without seizures. The patient had mental retardation with language problems, movement disorders and she was brought to our hospital twice for treatment. After treatment her head and trunk strength was increased. In the supine position she could turn over, had flexible movements and her head control was good. She can maintain a sitting position by herself but cannot sit up, stand or walk. Her cognitive function was improved, her concentration ability was better than before, she can say simple words such as "yes, baba, mama" and she can understand the language of the family. She can control her urination function and when she was hungry, thirsty or wanted to go to the toilet she can communicate but the oral language was meaningless.
Her physical condition is good, her sleep, diet, urination and defecation functions are normal.

Admission PE:
Bp: 103/68mmHg, Hr: 92/min, breathing rate: 20/min, body temperature: 36.6 degrees. Height: 136cm, weight: 30Kg. The patient had developmental delay  but the nutrition status is good. There is no injury or bleeding spots of her skin and mucosa, no congestion of throat and no tonsil swelling. The lungs breathing was clear with no rales, The heart beat was powerful with irregular cardiac rhythm and with no obvious murmur in the valves. The abdomen was soft and flat, with no masses or tenderness. Her liver and spleen were normal, there was no edema in the legs.

Nervous System Examination:
Patient was alert and her mental status was good. She can speak some simple words such as “yes, baba, mama” and she can understand others  responding with facial expressions. She cannot complete the examination of the memory, orientation and calculation ability tests. Both pupils were equal in size and round, diameter of 2.5mm, react slowly to light, her eyes can chase things but are less flexible. Her musculus ocularis cannot move coordinately, both eyeballs always display abduction or adduction in the same time and she could not complete the cranial nerves function examination. Swallowing function was normal, she can take food as normal with no choking. She can control the neck well and can raise her head up and turn the head whilst in lying down position. Her four limbs can move, she can roll over in bed herself but she cannot sit up or stand up independently. She can maintain the sitting posture once we assisted her to sit up. With support she can step, her hands can lift and grasp with left side being much better. Left hand grip force is 4 degrees, right hand grip force is 3 degrees. Her legs can move freely, she can bend or stretch legs in bed. Arm muscle power was normal and increased in her legs. The bilateral biceps reflex is normal, patellar tendon reflex of both sides was active, ankle clonus was positive, abdominal reflex is normal. Sucking reflex of both sides is negative, Babinski sign is negative, Palm-jerk reflex is positive. She cannot complete  the examination of the sensory, coordinate movement and the meningeal irritation sign is negative.

After the admission she received related examinations and was diagnosed with 1. Chronic encephalopathy, West Syndrome 2. Sinus Arrhythmia. She received 3 times nerve regeneration treatment to repair her damaged brain nerves, initiate brain nerve develop, nourish nerves, regulate her immune system and improve blood circulation. This was done along with rehabilitation training.     

After 27 days of treatment her cognitive function was much better. Her comprehension ability was much improved, she can understood more of her parents’ language, she could speak more words and with greater clarity. Her trunk muscles power increased, she is able to keep in a sitting position and standing position longer. Her hands are more flexible and powerful than before and she is able to walk longer with some help.

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