Yehoshua Avichail-Parkinson Syndrome-(Israel)

Name: Yehoshua Avichail 
Sex: Male
Nationality: Israeli
Age: 57Y
Diagnosis: Parkinson Syndrome

Before treatment:
The patient felt limb stiffness 5 years ago, he moved slowly and his condition became worse and worse. His daily life was affected so he went to a local hospital and was diagnosed with Parkinson Syndrome. He used oral medicines but his condition did not improve. 1 year ago he was unable to speak clearly, he moved slowly and he felt pain in whole body. For now he takes carbidopa but his condition is not better. He is unable to take care of himself, has memory loss and is slow to react.
His sleep, diet, urination and defecation functions are normal.

Admission PE:
Bp: 131/86mmHg, Hr: 94/min, body temperature: 36.3 degrees. Breathing rate: 19/min. He was humpbacked when standing, walked slowly and  had rigidity with  nearly no arm swing when walking. He tired easily but his nutrition status was fine. There were no broken or bleeding spots on his skin and mucosa, no lymph nodes swollen and no tonsil swelling. The respiratory sounds in both lungs were clear and there was no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was flat and soft, with mild  muscle tension, no tenderness or rebound tenderness and with no masses. The liver and spleen were in the normal position by touch and there was no edema of the legs.

Nervous System Examination:
Patient was alert, slurred and slow in his speech. His orientation, cognitive function and calculation abilities were normal. Both pupils were equal and round, diameter of 3.0 mm, react well to light, eyeballs can move freely and there was no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, he could extend his tongue out, had slight tongue muscle tremor and could not move his tongue very well. Bilateral soft palate could lift powerfully, the uvula was normal. He could turn his head as normal but the shrug ability was weak and clumsy. He had slow movement ability with all 4 limbs. There was no obvious body tremor, muscle power of left body side was 4 degrees,  right side was 4+. He had difficulty to roll over in bed, get up or walk but can walk with support. The 4 limbs muscle tone was normal. Bilateral biceps reflex, triceps reflex and radial periosteal reflex were normal. The patellar tendon reflex and Achilles tendon reflex were low. Bilateral Hoffmann sign was negative, the Rossilimo sign was positive. Bilateral sucking reflex was negative, the palm-jaw reflex of both sides were negative. Bilateral Babinski sign was negative, his sensory and fine sensory  results were normal. Patient can perform the finger opposite movement and fast alternate movement but with clumsiness. The finger to nose test was normal and he could perform the heel-knee-tibia test in a stable manner. The Romberg's sign was slightly positive, he was tending to fall backwards when he was walking. The meningeal irritation sign was negative.

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

Post-treatment:
After 13 days treatment the patient's condition was stable, his spirit and motion were better, his memory ability was improved, the slow movement symptoms improved, he had better facial expression and he spoke clearer. His four limbs were more flexible, his fingers were much more flexible, his standing position was much better, his balance function was better and he walked better. He was able to walk by himself for a short distance and the muscle pain in his whole body was reduced.

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