Maia-Secondary epilepsy-(Argentina)

Name: Maia Abril Isabella Valenzi                      

Sex: Female

Country: Argentina

Age: 10

Diagnoses: 1.Cerebral palsy 2. Congenital hydrocephalus Post ventricular peritoneal shunt 3. Secondary epilepsy

Before treatment:

The patient was a full-term normal delivery 9 years ago. The patient was found to have hydrocephalus when her mother was 32 weeks pregnant. The patient received a ventriculoperitoneal shunt on the fifth day after birth. The patient's intelligence and motor development was more delayed than a normal baby. But she still had simple language and movement. The patient burst into generalized convulsion without reason in 2006. The convulsion lasted about 45 minutes. The patient was quickly sent to the hospital and received medication to control the convulsion. The patient's speech and motor function was slower than before the epileptic seizure. The pronunciation and motor function was constrained. At present, the patient takes Phenobarbital 0.05g one in the morning and one in the evening, Diazepam 3.75mg one in the morning and one in the evening. The growth and development are retarded. She has no language. She can't turn over or sit up, only drinks liquid. There is no activity of the four limbs. She has gatism. There is deformity of the spinal column and scoliosis. She receives rehabilitation each week 4 times and had slight progress.

Admission PE:

Br: 23/min, Hr: 81/min, BP: 130/85mmHg, Temperature: 36.0 degree. Height: 131cms, weight: 19kgs. The patient was bedridden and had compulsive position. Both upper limbs were bent and both lower limbs were straight. Her head bend to the right out of habit. The vertebral column was bent to the left side. The head had no deformity. The gum had obvious hyperplasia.

Nervous System Examination:

The patient was alert and had good spirits. Patient showed oligophrenia, response and comprehension was delayed. She couldn't cooperate with the examination completely. She only had phonation and had no speech. Both eyeballs had vertical tremor and the right side was more severe. There was no blepharoptosis. Bilateral nasolabial sulcus was symmetrical. The tongue was in the center of the oral cavity. The soft palate could rise normally. The uvula was in the center. The pharyngeal reflex was weak. There was obvious gum hypertrophy. She couldn't cooperate with other cranial nerve examinations. The neck had no resistance. Both upper limbs had autonomic activities. Give the patient pain stimulus, the patient's lower limbs had evasive action. She could not cooperate with the examination of muscle strength. Both lower limbs had no autonomic activities. There was limited activity of right hip joint, and the joints had obvious pain when outreach passively. She couldn't turn over or sit up. The muscle tone of four limbs was higher than normal and about 3 level. The patient showed tendon hyper-reflexia of four limbs. Bilateral ankle clonus was positive. Bilateral abdominal reflexes were not elicited. Bilateral palm jaw reflex was negative. Bilateral Hoffmann sign was negative. Left side Babinski sign was positive and right side Babinski was negative. She couldn't cooperate with the examination of sensory system and coordinate movement. There was no meningeal irritation.

Treatment:

After admission, the patient received related examination. The patient received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves and nourishment for the neurons. She also received medication to adjust anticonvulsants. This was combined with daily physical rehabilitation therapy.

Post-treatment:

The patient has more sensitive comprehensive ability and reaction capacity. She has more flexible action of sucking lips. She cough less times when she has diet. Her habitual actions are reduced as compared to before, when she is sleeping. The gum hypertrophy is alleviated. The range of upper limbs' motion is slightly increased. Sometimes, she can finish the family member's instruction on purpose. Before the treatment, the patient couldn't loosen hands naturally. At present, she has more flexible grasp action. Bilateral ankle clonus was negative. The tendon reflex of four limbs is weaker. Both lower limbs have autonomic activities and the muscle strength reaches level 2. She could finish the lower limbs transition and the left lower limbs can transit better. The range of right hip joint motion is increased. After the passive abduction, there is no obvious pain reaction. The muscle tone of both lower limbs is lower than before. There is no obvious spasm attack.

Maia's mother emailed to us:

Date: 2013-05-20

Subject: control Maia Abril Isabella valenzi

hello doctor, I am maia's mom miriam isabella Valenzi April, we traveled in August 2012, could not communicate with you. because they had blocked my mail and lost all contact email addresses until I went back to get it by Degano sofia breast.

I tell him about the incredible evolution of Maia.

1 - we primeron china and everyone noticed and even doctors from here after a month of not seeing her, that Maia had another look, was connected ... left her isolated world to integrate into our ...

2 - has intension to use the upper limbs (before his brain did not send signal to the body) ...

3-have mobility in fingers and look to move (once used the arms as hooks to grab things, now use your hands and ... discover your body movements) ...

4-began to move his thumbs and mita and play with them (she had the muscles of the thumbs disconnected, dead) ...

5 - try to issue new sounds and some words, water, oh god, baby! cries when going to bathe, when we ale aunt asked if she was tired of the trip for what maia replies: aja ....

6-began to control the head and keeps it for longer ...

7 - improved trunk control and thorax ...

8 - the most important thing ... is descolapso the lung, spine was crushing a lung clearance ... but now since we returned and had no respiratory maia when prior to treatment had monthly.

9 - expresses joy, anger, playing with siblings ...

10 - grew in 7 months 30 cm (muchisimooo)

11 - is ecerco more at his age, is more mature

The truth is exciting to see so changed maia is another baby, very knowledgeable, and I really love to know if we could repeat the treatment due to the previous success.

Since already very grateful ..... Miriam

Miriam cordoba
 

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