Ms. Bennetts-Progressive Bulbar Palsy-(Australia)

Name: Ms. Bennetts
Sex: Female
Nationality: Australian
Age: 63Y
Diagnosis: Progressive Bulbar Palsy(PBP)

Before treatment: 
The patient felt uncomfortable in her throat 6 months ago. Her speech was weak and lower than normal. She went to hospital and did MRI, blood, PET, CT and EMG testing and she was diagnosed with PBP. 3 months later she began to have problems with swallowing food and especially when she drinks water. Her condition got worse and worse and she also had problems with breathing. At present her language ability, swallowing function and respiration function are bad. She is unable to speak clearly and sometimes she chokes when drinking.
Her spirit and sleep are good but her appetite is bad. Her urination and defecation functions are normal.

Admission PE:
Bp: 146/86mmHg, Hr: 57/min, breathing rate: 18/min, body temperature: 36.3 degrees. Blood oxygen concentration was 91-93%. Height: 167cm, weight: 95.5Kg. She had normal physical development and her nutrition status is good. There is no injury or bleeding spots of the skin and mucosa, no congestion of the throat but she had lots of drooling. Chest development is normal with a post bilateral mastectomy, chest movement decreased when she was breathing. The breathing sounds in the lower part of the lungs was slightly weakened, there were no rales. The heart beat was powerful with regular cardiac rhythm and no murmurs. The abdomen was soft and flat with no masses or tenderness. Her liver and spleen were normal, shifting dullness is negative,  spinal column is normal, there was mild edema in the feet with normal dorsalis pedis pulse.

Nervous System Examination:
Patient was alert, mental status was slightly weakened. She had slurred speech. Her memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light and had no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical, she can make her tongue extend out as normal and there  was no tongue muscle atrophy. Showing the teeth was normal, she can bulge the cheeks but with difficulty. Chewing ability was reduced, the bilateral soft palate can lift, the pharyngeal reflex was weak and the uvula was in middle. Her neck was soft, she could turn her head and shrug powerfully. The 4 limbs muscle power were 5 degrees with the muscle tone normal. Her  tendon reflex in the arms was normal but weak in the legs. The bilateral Hoffmann sign was negative, the Babinski sign of both sides was negative, the finger to nose test, fast alternate movement and finger opposite movement were normal. The meningeal irritation sign is negative.

Treatment:
After the admission she received related examinations and received 3 times nerve regeneration treatment to repair her damaged nerves, replace dead nerves, nourish nerves, regulate her immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 15 days treatment her drooling reduced, appetite improved, she could bulge her cheeks much better than before and she could make her voice much louder.


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