Lucy-Parkinson's disease-(Canadian)-Posted on October 6, 2012

Name: Lucy                  
Sex: Female
Country: Canadian
Age: 59
Diagnosis: Parkinson's disease
Admission Date: September 13, 2012
Days Admitted to Hospital: 23 days

Before Treatment:
The patient suffered from a static tremor of the left hand without obvious reasons 10 years ago. She went to the local hospital and was given an MRI examination, she was diagnosed with Parkinson's disease. She took Madopar 125mg each time to treat the tremor. The tremor enlarged to the left lower limb and right lower limb. So she took more Madopar for treatment and add Comtan to control the disease. The pharmaceutical effect decreased gradually. About 4 years ago, the patient had myotonia. When the myotonia broke out, the left limb was stiff and had difficulty with walking. So the patient's dosage was increased along with the number of times it was taken gradually. The controlling of the symptoms was unsatisfactory. And the patient had abnormal movement after taking the medication. Before the treatment, the patient took Madopar 500mg, Comtan 200mg each time, and took medication every 2.5-3 hours. Each time before taking the medication, the patient felt pantalgia, nervous. She couldn't walk, along with tremors and weakness.

Nervous System Examination: 
Lucy was alert, and her speech was clear. Amimia, she had no expression on her face. Her memory, calculation abilities and orientation were normal. Both pupils were equal in size and round, the diameter was about 3.0mm. The movement of both eyeballs was flexible and both pupils were sensitive to light stimuli. There was no obvious nystagmus. The converge ability of both eyes was poor. The forehead wrinkle pattern and nasolabial groove were symmetrical. The tongue was centered in the oral cavity and there were slight tremors in the muscles of the tongue. The muscle strength of the raised soft palate was normal. The uvula was in the center. She could swivel normally. The shrug strength of shoulders was level 4. The left upper limbs had static tremor. There was abnormal action of lower limbs. The muscle strength of both upper limbs was level 5. The muscle strength of both lower limbs was level 4. The muscle tone of four limbs was normal. Bilateral biceps reflex, triceps reflex, radioperiosteal reflex, patellar tendon reflex and Achilles tendon reflex were normal. Bilateral abdominal reflexes were not elicited. Bilateral pathologic reflex was negative. She had almost normal fine and deep, shallow sensation. The left limb was able to do the finger nose test, the rapid rotation test and the digital opposition test, but in a clumsy manner. The right limb was able to do the finger nose test, the rapid rotation test and the digital opposition test in a stable manner. She was able to do the heel-knee-shin test in a stable manner. She walks with no obvious swing arm action. Romberg's sign was positive. She had poor balance ability when standing on a single foot. There were no signs of meningeal irritation.

Treatment:
Lucy received all of the relevant examinations. She was diagnosed with Parkinson's disease. She stopped taking Madopar and Comtan. She took Sinemet and Piribedil sustained-release tablets for anti-Parkinson. She was, also, given treatment in order to expand the blood vessels, nourishment for the neurons and clear up oxygen free radicals in the brain. This was combined with physical rehabilitation training and language training.

Post-Treatment:
The frequency of Lucy taking anti-Parkinson medicine is reduced. She takes medication 4 times each day. She has better control of limbs tremor and myotonia. The generalized pain is obviously alleviated. She has a better appetite and has gained 2kg weight. Her expression is more natural. The converge ability of both eyes is better than before. There was no obvious tremor in the tongue muscles. The shrug muscle of both shoulders is level 5. Left limb has a slight tremor. Occasionally, the left lower limb has abnormal action. The muscle strength of lower limbs was level 5. She is able to finish the finger nose test, the rapid rotation test, the digital opposition test and the heel-knee-shin test in a stable manner. The swing arm action is coordinated when she walks. Romberg's sign was negative. The balance ability when she stands on a single foot is better. During admission to our hospital for two weeks, the patient slept poorly. She had dreaminess and somniloquy. She moved things and sat up during the somnia. After the symptomatic treatment, the patient's condition is better.