Moshe Arie Horowitz-Parkinson's Disease-(Israel)

Name: Moshe Arie Horowitz
Sex: Male
Nationality: Israeli
Age: 78Y
Diagnosis: Parkinson's Disease
Discharge Date: 2019/08/07

Before treatment:
The patient developed static tremor in the right arm five years ago and had no sensory abnormalities. He was diagnosed locally as having "Parkinson's disease" and was treated with oral dopa drugs. After treatment the tremor was  improved and the condition was stable for three years. It aggravated a year and a half ago with static tremor gradually appearing in the other limbs with slow movement, mild disturbance of the balance function, slow turning over, and inflexible fine movement of fingers.
At present the patient's limbs can move well and he can walk independently but accompanied by static tremor of the limbs. He can take care of himself.
His diet was normal and the number of nocturnal urinations has increased up to three times per night in the past two years.There was a history of cardiac pacemaker implantation.

Admission PE:
Bp: 106/71mmHg, pulse rate: 60/min, breathing rate 17/min. The patient has a symmetrical body build, a slightly unstable walking gait, good nutrition, mild sense of waves at the radialis side. There were no yellow stains or bleeding spots of the skin or mucosa except for red swelling of the right middle finger tip. There was no congestion of the throat, clear respiratory sounds of both lungs, no dry or moist rales heard, low and weak heart sounds, no murmur heard in the valves, a flat and soft abdomen, no tenderness or rebound tenderness, no masses found by touch, normal liver and spleen and no edema of the legs,.

Nervous System Examination:
The patient was alert, had clear normal speech with normal memory,  calculation, and orientation abilities. Both pupils were round and equal in size, with a diameter of 2.5 mm, reacting sensitively to light. There was free eyeball movement, no nystagmus and normal convergence of both eyes. Symmetrical forehead wrinkle and nasolabial fold, flexible blink reflex, tongue was in the middle when extended, mild tremor of the tongue, unremarkable tongue muscle movement and strong soft palate-lifting power bilaterally. There was  no deviation of the uvula and good neck-turning movement. There was slightly slow movement and static tremor of the 4 limbs, especially that of the right arm. Muscle power of the 4 limbs is grade 5- and he has a strong shrug. He finds it difficult to get-up in the morning, has starting difficulty when walking but with basically normal muscle tone of his 4 limbs. Bilateral biceps and triceps reflexes were not induced. There was a weak radioperiosteal reflex whilst the bilateral keen tendon reflex and heel tendon reflex were not induced. Bilaterally negative Hoffmann sign, Rossilomo sign, sucking reflex, palm-jaw reflex and Babinski sign. There was normal deep, superficial and fine sensation, slightly slow finger to finger and fast alternate movement with the right side  worse than the left side. Finger to nose movement is remarkable.  And he has a stable and accurate heel-knee-shin movement and a negative Romberg’s sign. Walking in a straight line can be finished and standing on one leg can generally be done. There was a negative meningeal irritation sign.

Treatment:
After the admission he received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged brain nerves, replace dead nerves, nourish nerves (ganglioside, nerve growth factors and neurotrophic factors), improve body environment, regulate his immune system and improve blood circulation. This was combined with with rehabilitation training. 

Post-treatment:
After 14 days treatment the bilateral fine movement of his hands got more flexible, there has been improvement in the static tremor, starting difficulty and slow movement. He could now write better, his morning stiffness was better and it became easier for him to get up from  bed. His balance function was better, he got to be able to stand on one leg for more than 15 seconds and his frequent micturition was  improved to now 1-2 times each night.

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