Frank Jusy Toya - Parkinson's Disease (Nigeria) Posted on August 18, 2014

Name: Frank Jusy Toya  
Sex: Male
Country: Nigeria
Age:47 years
Diagnoses: Parkinson's Disease, Type 2 diabetes, Hypertension level 1
Date:July 30, 2014
Days Admitted to Hospital: 13 days

Before treatment:
            The patient suffered from tremor of right upper limb 12 years ago. The disease progressed gradually and he was diagnosed with Parkinson's Disease in a local hospital. He took sinemet for treatment. After taking the medication, the patient's symptoms was alleviated, but the disease still progressed gradually. His four limbs presented with bradykinesia. The right limbs was more severe. The treatment effect was not good. Before the treatment, the patient suffered from bradykinesia of his four limbs. Right side was more severe. Right lower limb mopped the floor sometimes. He suffered from barylalia and low voice. The patient had micrographia. The patient sit-ups and turns over slowly. He could stand and walk by himself. But the stability was poor. He had less expression. He had a grim expression and depressed.

            From the onset of disease, the patient had normal diet. His weight was reduced. The sleep quality was not good. He sleeps 3-4 hours each day. He couldn't sleep all the night. He had constipated and 2-3 times each day. He urinate too many times and had urgent urination occasionally. There was no genetic disorders.

Admission PE:
            Bp: 124/81mmHg; Hr: 78/min. There was no congestion in pharyngeal area. The tonsil was not enlarged. The respiration in both lungs was clear, no dry or moist rales. Through auscultation, the heart sound was strong, with no murmur in each valve. The abdomen was flat and soft, with no masses. The liver and spleen was not touched under the rib. There was no swelling in both lower limbs.

Nervous System Examination:
            Frank Jusy Toya was alert and his voice was low. The speech was not clear. He had poor speech speed control. His memory and orientation were normal. The calculation was poor and only could calculate the first step. He had a masked face. Both pupils were equal in size and round, the diameter was about 3.0mm. Right pupil was sensitive to light stimulus. But left side was slow to light stimulus. Both eyeballs could move freely to each sides. He had convergence defect. He blinked eyes with discordant action. He had horizontal nystagmus. The forehead wrinkle pattern was symmetrical and bilateral nasolabial grooves was symmetrical. The tongue was in the center of oral cavity. There was slight tremor in tongue. He had strong muscle to lift his soft palate. The uvula had not deflected. He could turn head with slow manner. The movement of limbs was slow. Right upper limb had slight tremor, other limbs had no obvious tremor. The muscle strength of both upper limbs was at level 5-. The hold power of both hands was at level 5. The muscle strength of both lower limbs was at level 4-. His right lower limb was used to mop the floor when he walked. The muscle tone of both upper limbs was slightly increased. The muscle tone of both lower limbs was increased and right side was more severe. There was muscle atrophy in both lower limbs and left lower limb was more severe. Bilateral biceps reflex, triceps reflex and radioperiosteal reflex were weak. Bilateral patellar tendon reflex was not elicited. Bilateral Achilles tendon reflex and abdominal reflexes were normal. Bilateral Hoffmann sign was negative. Bilateral Rossilomo sign was negative. Bilateral sucking reflex was positive. Bilateral palm jaw reflex was positive. Bilateral Babinski sign was negative. The deep sensation, shallow sensation and sophisticated sensation were normal. He did finger-nose test and fingers coordinate movement in a stable manner, but the action was slow. He did the rapid rotation test in a clumsy manner. He did the heel-knee-tibia test in a stable manner. He walked and turned back slowly. Right foot would mop floor sometimes. The Romberg sign was positive. Meningeal irritation was negative.

          Frank Jusy Toya received all of the relevant examinations and was diagnosed with Parkinson's Disease clearly. FBG (fasting blood-glucose) after admission was 13.56mmol/L, 2-hour postprandial blood glucose was 16.5-26.1mmol/L. He was diagnosed with type 2 diabetes. We monitored his blood pressure for 3 times, all the results were higher than 140/90mmHg. He was diagnosed with Hypertension level 1. The patient received treatment for nerve regeneration and to activate stem cells in vivo. He received treatment in order to expand the blood vessels in order to improve the blood supply to the brain and to provide nourishment to the neurons. He also received treatment to remove oxygen free radical. This was combined with physical rehabilitation training.

           The patient's computation power is normal. The masked face is alleviated. Both pupils are sensitive to light reflection. The bradykinesia of limbs is alleviated. The mild tremor of right upper limb has disappeared. The muscle tone of his four limbs is normal. The blood sugar has reduced progressively. 

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