Ronnie-Progressive Supranuclear Palsy-(USA)

Name: Ronnie Earl Bunnells             
Sex: Male
Country: USA
Age:62 years
Diagnosis: Progressive Supranuclear PalsyDate:May 10, 2014
Days Admitted to Hospital: 21 days

Before treatment:
The patient suffered from paroxysmal dizziness 4 years ago without obvious inducement. His walking gait was unstable. His disease was aggravated and the movement of both eyes was limited. He only could peer upwards. His limbs were stiffened gradually. The development of his movement and speech was slow. He went to a local hospital and received MRI examination. He was diagnosed with progressive supranuclear palsy. He took Amitriptyline for treatment. After taking the medication, he suffered from excitement and hallucination. So he stopped the medication. Then he proceeded to many hospital and received no special treatment. The patient also suffered from urinary incontinence 2 years ago. At present, the patient is kept in bed. He has walking difficulty. He can't take care of himself and needs assistance from family members.

From onset of the disease, the patient had apnea at night. His appetite was almost normal. His weight had no obvious change. There was no familial hereditary disease.

Admission PE:
BP: 119/73mmHg, HB: 88/min, BTM: 20/min. Body temperature 36.2 degree. He was in a normal figure, his diet was normal. The respiratory sounds in both lungs were clear with no signs of dry or moist rales. The rhythm of his heartbeats was regular without obvious murmur in the valves. His abdomen was soft and large without pressing pain or rebound tenderness. The liver and spleen had not enlarged. His lower limbs were not swollen.

Nervous System Examination:
Ronnie was not very alerted. His spirit was weak. He was slow in speaking. His tone of speech was normal. His memory, calculation, orientation examinations were normal. His response was fine. His pupils were of equal size and round with the diameter of 2.5mm. His pupils were flexible to the light stimulus. His eyes had congestion. He always looks above. He could hardly blink, move his eyeball to left or right or look down. He could not raise his eyebrow up. He had a stiff face. His bilateral nasolabial sulcus was equal in depth. The tongue and the teeth were in the center of the oral cavity. He moved his tongue in a slow way. He could easily raise his soft palate. The neck was weak.  The muscle strength of his four limbs were of 5-. His grip power was normal. His limbs were stiff when he walked. The bicipital muscle of both arms and patellar tendon reflex could be elicited. The achilles tendon reflex was weak. The abdominal reflex could not be elicited. The deep and shallow sensation examination were almost normal. The sucking reflex was positive. The paw and jaw reflex was positive. The bilateral Babinski sign were neutral. The rotation of both hands, the finger-to-nose performance and the heel-knee-shin performance were slow and clumsy. He could not keep his balance when he closed his eyes. There were no signs of meningeal irritation. The oxygen saturation; 93-95%.

After admission, we conducted a complete examination on Ronnie. In conclusion of series of examinations on his body, we confirmed the diagnosis of Progressive Supranuclear Palsy, sleep apnea and Hyperlipidemia. He was given treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and he was also given medicines for the neurons. This was accompanied with daily rehabilitation training. He received treatment for nerve regeneration and to activate stem cells in vivo. Non-invasive ventilator was also used to improve the condition of sleep apnea.

After the treatment, Ronnie's speech is clearer than before. The voice is louder as well. He can blink his eyes quicker than he was admitted. His eyes now can move to left side and right side, they also move faster than before. The dizziness has been greatly alleviated. His movement is more flexible than before and his balance also got better. Now it is much easier to help him to walk. The sleep apnea symptom also alleviated after he used the non-invasive ventilator and the blood-oxygen level has reached 96-98%. 


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