Dora Oved-Oculopharyngeal muscular dystrophy OPMD-(Israeli)

Patient's Name: Dora Oved
Gender: Female
Age: 67 years old
Nationality: Israeli
Diagnosis: Oculopharyngeal muscular dystrophy

Admission condition:
The patient was admitted due to a progressive weakness and muscle atrophy of the eye and pharyngeal muscles with accompanying muscular atrophy, lasting for 3 years, which has worsened along with a decrease in strength in their extremities, which is diagnosed as 'Oculopharyngeal muscular dystrophy'.

Inpatient physical examination:
The patient's blood pressure is 135/64 mmHg, heart rate is 58 beats per minute, and respiratory rate is 20 times per minute. Her height is 154 cm, weight is 45 kg. Her respiratory sounds are clear in both lungs, without obvious dry or moist rales. Her heart sounds are strong and regular, without obvious murmurs. Her abdomen is flat and soft, with a feeding tube visible in the stomach. There is tenderness in the right upper abdomen, without rebound tenderness, and the liver and spleen are not palpable.

Neurological examination:
The patient was clear in her mind, with a normal voice and a slow speech rate. Her memory and calculation abilities were basically normal. Her pupils were equal in size and round, with a diameter of 2mm. There was a response to light, but both horizontal and vertical eye movements were limited. The forehead furrows have become shallow, and there was weakness in closing the eyes. There was significant atrophy of the eyes and face muscles. The lids of both eyes drooped, and there was weak lifting of the lid to close the eyes, with incompletion of the closure of the left eye lid (montal sign positive). The bilateral nasolabial furrows were symmetrical, and the tongue was midline, with no deviation when shown the teeth. There was weakness in puffing cheeks. She had weak upper eyelid elevation and difficulty swallowing. She also had mild atrophy of the muscles in her shoulder blades and limbs. Her left upper limb had grade 3 muscle strength, right upper limb had grade 3+ muscle strength, left hand had grade 3 grip strength, right hand had grade 3+ grip strength, and her left lower limb had grade 3 muscle strength and the right lower limb had grade 3+ muscle strength. She could only maintain balance for 2 seconds with one foot standing. Her gait was slow and her exercise endurance was poor, as she felt fatigue after walking for 5-10 minutes. Her muscle tone in the four limbs was slightly low, and her tendon reflexes were generally normal. Her pathological signs were negative, and her deep and superficial senses were generally normal. She could complete the finger-nose test, pointing fingers test, and rapid alternating test on both sides of her body, as well as the heel-knee-shin test on both legs, but the speed was slow.

Treatment process:
The patient was diagnosed as having " Oculopharyngeal muscular dystrophy" upon admission. She was given CAST therapy to improve the body's environment, with comprehensive treatment including mesenchymal stem cells + neural stem cells, repairing muscle fibers, nourishing muscle tissue, improving blood circulation, regulating the immune system, and undergoing rehabilitation training.

Post-treatment:
The patient has shown marked improvement with a noticeable improvement in muscular strength in the ocular and pharyngeal regions as well as limbs, while opening her eyes her palpebral fissure has widened, closing eyes firmly and ptosis of upper eyelids is largely resolved. Her swallowing function has improved significantly and she can swallow foods like bread with a significantly increased intake of food through oral ingestion. She has experienced a 30% increase in muscle strength in all four limbs, with significant improvement in the strength of her upper limb lifting and grasping. She can perform hand grip tests with strength of about grade 4+ in her left upper limb and left hand, and grade 5- in her right upper limb and right hand. She has seen improvement in her lower limb walking function, with faster walking speed and the ability to perform single-leg standing. Her left lower limb muscle strength is around grade 4+, while her right lower limb muscle strength is around grade 5-. She has also experienced a significant increase in energy, physical stamina, and exercise endurance.