Mihael Perusko-Duchenne Muscular Dystrophy-(Croatia)-2nd round

Patient Name: Mihael Perusko
Gender: Male
Age: 10 years old
Nationality: Croatia
Diagnosis: Duchenne Muscular Dystrophy

Pre-treatment:
A 10-year-old patient with progressive muscular weakness, difficulty walking, difficulty getting up from bed, inability to stand up by themselves, easy palpitations after mild exercise, with no abnormal sensation, and no urinary and bowel disorders. One year ago, he came to our hospital for treatment, and his motor function improved significantly after treatment.

Physical Examination upon Admission:
The patient's blood pressure was 114/88 mmHg, heart rate was 102 beats/min, and it increased to about 115-120 beats/min after activity. His blood oxygen saturation was 95%. There were no jaundice or bleeding points on his skin. His lungs had clear breathing sounds with no dry or wet rales. His heartbeat was strong, sometimes irregular. His abdomen was soft without hepatomegaly or splenomegaly.

Neurological Examination:
The patient's mind was clear, words were fluent, and his memory and calculation ability were normal. There were no abnormalities in his cranial nerves upon examination. He turned his neck and shrugged his shoulder muscle strength was grade 4-, his proximal upper limb muscle strength was grade 3-, distal muscle strength and grip strength was grade 4; his proximal lower limb muscle strength was grade 2, distal muscle strength was grade 3-, he could not lift his legs off the bed when he was lying down, and the translation speed was slow, he could not stand up from the sitting position, he walked slowly, his gait was unstable, like a duck gait. Pseudohypertrophy was seen in his bilateral gastrocnemius muscles. The muscle tone of his limbs was basically normal. The tendon reflex of his extremities was weakened. The pathological signs of his limbs were negative. There was nothing wrong with his body sensation. His bilateral finger-nose test was stable and the rapid rotation test was flexible. His bilateral calcaneus knee tibia test could not be completed due to muscle strength. It is difficult for him to establish a standing stably with his eyes closed. He stood on one leg for 1-2 seconds. His meningeal irritation sign was negative.

Treatment Process:
The patient's diagnosis upon admission was clear for "Duchenne Muscular Dystrophy." He was given CAST therapy and combined stem cell therapy of mesenchymal stem cells and neural stem cells to repair muscle fibers, nourish muscle tissue, improve circulation, regulate immunity, and provided comprehensive rehabilitation training.

Post-treatment:
The patient's motor function improved, and he could independently complete activities such as getting up and turning over in bed, standing up from a low sitting position, etc., with significantly improved flexibility and speed of movement; his single-leg standing time increased to over 5-10 seconds, with significant improvement in stability; his walking function improved, with faster walking speed and better gait, improved balance; his limbs muscle strength increased, with increased muscle strength of his both upper extremities (proximal and distal) to grade 4+ and his lower limbs (proximal) to grade 3+, his distal muscle strength to grade 4; overall muscle strength increased by approximately 30% compared to before admission; his heart function improved, with a decrease in the frequency of arrhythmia attacks and fewer palpitations after exercise; his heart rate averaged between 70-85 beats/min.