Mr.Ali-Cerebral Palsy-(Pakistan)

Name: Mr.Ali
Sex: Male
Nationality: Pakistani
Age: 18Y
Diagnosis: 1. Cerebral Palsy 2 Asthma

Before treatment:
The patient was born by caesarean operation after his mother was pregnant for 9 months. He was unable to cry when he was born and he had developmental retardation in motor and intelligence functions. His learning ability was low. He was taken to hospital and had a brain MRI which showed there was encephalatrophy, layers of cerebral cortex and white matter problems. He was diagnosed with Cerebral Palsy. His spirit, intelligence, language ability and motor functions were all delayed. At present his spirit is good, he is able to talk with others and his memory is normal. He is able to move his arms but he is unable to move his hands well. He is able to turn on the TV, drink water and eat. He is able to walk with someone’s help but his gait is abnormal. When he is walking, his knees and hip joints are not straight. He is able to crawl and sit by himself.

Admission PE:
Bp: 118/62mmHg, Hr: 107/min. Height: 154cm, weight: 50Kg. The skin and mucosa are intact with no yellow stains or bleeding spots. Chest development is normal, the respiratory sounds in both lungs were clear with no dry or moist rales. The heart beat is strong with regular cardiac rhythm and with no obvious murmur in the valves. The abdomen was soft and bulging, with no masses or tenderness. Liver and spleen were normal by touch.

Nervous System Examination:
Patient was alert and his mental status was fine, he can communicate with others as normal, the comprehensive ability and cooperating ability were good, the memory, orientation and calculation abilities were normal. Both pupils were equal in size and round, diameter of 4.0 mm, react well to light and with no nystagmus. Bilateral forehead wrinkle and nasolabial groove are symmetrical. He can make his tongue extend out as normal, the soft palate can lift as normal. The arms can move with flexibility except for the hands. He could open or close the door, turn the  television on and  he can drink and eat as normal. The legs had movement disorder but he can walk with assistance. There is an abnormal gait, a scissors gait so when walking his knee and hip joint were bending. He can crawl quickly. He could maintain a sitting posture and the trunk support ability when he sat was basically normal.  Muscle power of the arms was 5 degrees, both hands grip force were 4 degrees, muscle power of the legs was 3 degrees. Muscle tone of the arms were normal, the legs were higher than normal. He had tight tendons in both the knee and ankle joints and he cannot straighten his knee joints. The left side was 135 degrees, and right side was 145 degrees. Tendon reflex of all 4 limbs were normal. Abdominal reflex of both sides was normal. The Hoffmann sign of both sides was positive, sucking reflex of both sides was negative, bilateral Palm-jaw reflex was positive, jaw reflex was negative, right side Babinski sign was positive, left side was neutral and he has flat-feet. The sensory system examinations were normal. Left hand finger opposite movement was normal, on the left side there was some shaking, bilateral fast alternate movements were clumsy, the heel-knee-tibia test was normal, 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 14 days treatment his motor functions were better. His fingers were more flexible, his leg adductor muscle tone reduced, the muscle power of the legs was increased 30%. He walked for longer, his scissors gait was reduced and the knee joints contracture alleviated. His knee joints angle can now be 150 degrees.