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Mazal Betzalel-Inherited Mitochondrial Myopathy(Iran)

Author Zhangqi Views Posted at 2018/03/06

Name: Mazal Betzalel
Sex: Female
Nationality: Iranian
Age: 34Y
Diagnosis: 1. Inherited Mitochondrial Myopathy 2. Hypertension
Date of Admission: Oct. 26th, 2017
Treatment hospital/period: Wu Medical Center/12 days

Before treatment:
The patient fell down sometimes 13 years ago, it was hard  to lift her legs, she had a waddling gait and walking was difficult. She went to a local hospital but was not diagnosed. She began to do rehabilitation training but her condition got worse so she went to hospital again in 2005. She was diagnosed with inherited mitochondrial myopathy after doing a gene test. She was unable to move 1 year ago and  couldn’t take care of herself.
Her spirit, sleep and diet are normal. Her urination and defecation functions are normal.

Admission PE:
Bp: 121/90mmHg, Hr: 99/min, breathing rate: 18/min, body temperature: 36.5 degrees. Height: 170cm, weight: 98Kg. There is no injury or bleeding spots of her skin and mucosa, no congestion of the throat and no tonsil swelling. Chest development is normal, the lungs breathing sounds were clear with no rales, The heart beat was powerful with regular cardiac rhythm and no murmur in the valve areas. The abdomen was soft and bulging with no masses or tenderness. Her liver and spleen were normal. There was shoulder girdle muscle atrophy and mild winged shoulder. She cannot roll over in bed, sit up, or get up from bed independently.

Nervous System Examination:
Patient was alert, clear in her speech and the mental status was fine. Her memory, calculation and orientation ability are normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light with no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical and she can close her eyes normally. Her tongue can extend and move as normal, there is no tongue muscle atrophy, showing the teeth is normal, she can bulge the cheeks and lift  the soft palate as normal. Her  neck muscle turning power was 3-degrees, shrug muscle power was 2 degrees. She had difficulty to lift her arms with right arm proximal side abductor muscle power 3 degrees, adductor muscle power 3- degrees. The right distal side flexor muscle power was 1 degree, extensor muscle power was 1+ degree. The left arm proximal side abductor muscle power was 3- degrees, adductor muscle power was 2+ degrees. Left arm distal side flexor muscle power was 1 degree, extensor muscle power was 1 degree. Both hands grip force was 2 degrees. Muscle power of the legs was 2- degrees. The muscle power of all four limbs was lower than normal and the tendon reflex cannot be induced. The abdomen reflex cannot be induced, the bilateral Palm-jaw reflex was negative. Hoffmann sign and Rossilimo sign of both sides were negative. Babinski sign of both sides was negative. The sensory system and fine sensory examination were normal by gross measure. She cannot perform the  fingers to nose test, finger opposite movement or fast alternate movement on either side. She cannot do the heel-knee-tibia test and the meningeal irritation sign is negative.

Treatment:
After the admission, she received related examinations. She received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair her damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 12 days treatment her motor functions were better, arm muscle power increased, hand grip strength increased by nearly 1 level, her hands did fine motor movements easier. The activity of the legs increased, she raised her legs easier and her motor functions increased by 20%. Her blood pressure became controlled and was more stable.

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