Dmittry Martyanov - Parkinson's disease (Russia) Posted on July 2, 2012

Name: Dmittry Martyanov             
Sex: Male
Country: Russia
Age: 44
Diagnosis: Parkinson's disease
Admission Date: April 29, 2012
Days Admitted to Hospital: 27

Dmittry developed bradykinesia in the right arm in 2002. But the arm was still able to move basically and his life was not negatively influenced. Dmittry initially ignored this symptom and the bradykinesia gradually became more aggravated. Four years later, the left arm developed bradykinesia and at that time, he went to his local hospital and was given an MRI Examination. The diagnosis was Parkinson disease. The specific treatment Dmitry received there is unknown and the symptoms continued to get worse. Additional symptoms included a gradual and continuous decrease in walking speed. Dmitry was prescribed Madopar for treatment and the dosage of the medication fluctuated along with the symptoms. Eventually Dmitry's speech became vague. The increased mobility problems he experienced as a result of the bradykinesia often caused him to lose his balance and fall and it was obvious that the medication was ineffective.

Nervous System Examination:
Dmitry was alert, but his speech was ambiguous and he spoke quickly. The memory, calculation ability and orientation were normal. There was facial masking. Both pupils were equal in size and round, the diameter was about 3.0mms. The movements of both eyeballs were flexible and both pupils were sensitive to light stimuli. There was slight horizontal nystagmus. The convergence ability of the left eye was poor. The rapid blinking ability was normal. The forehead wrinkle pattern was symmetrical. There were tremors in the genioglossus. The raising ability of the soft palate was normal. The head could be turned to both sides, but only slowly. The body movements were slow. There were slight tremors in the hands. There were no obvious tremors in the arms or legs. The bilateral shoulder shrugging strength was level 5-. The swiveling ability of the right side was weak. The muscle strength of both upper limbs was level 5-; the muscle strength of both lower limbs was level 5. Dmitry had difficulty with starting his walking motion; his walking speed was slow with an unusual gait. He had obvious festinating gait or shuffling gait . He turned around slowly and needed to take 10 steps to completely turn round. His walking gait was unstable and he frequently fell. The muscle tone of all four limbs was almost normal. The bilateral biceps reflex, triceps reflex, radial periosteal reflex and patellar tendon reflex were normal. The bilateral Achilles tendon reflex and abdominal reflexes were not elicited. The bilateral Hoffmann's sign was negative. The bilateral Rossolimo's sign was negative. The bilateral sucking reflex was negative. The bilateral palm jaw reflex was negative. The bilateral Babinski's sign was negative. The deep, shallow, and epicritic sensation was normal. Both sides of the body were able to finish the finger-to-nose test and digit opposition test in a stable manner. The bilateral rapid rotation test was not flexible. The bilateral heel-knee-shin test was stable and accurate. The Romberg's sign was positive.

Treatment:
Dmitry received all of the relevant examinations and was diagnosed with Parkinson's disease. He received anti-Parkinson's medication and had the blood vessels expanded to increase the blood-supply, and he was given nerve nutrition. He also received treatment to get rid of the oxygen free radicals in the brain and had the gastric mucosa protected. This was combined with physical rehabilitation training. During Dmitry's stay at our hospital, he suffered from pain in the stomach and hypogastrium. There was no regular time pattern for the pain and the pain lasted about 2 hours. The patient was given pantroprazole, which alleviated the pain and the pain did not return.

Post-treatment:
The walking gait has improved. The arching of the back is not as obvious when he walks and the posture of the back is straighter and upright. The speech is easier to understand. The facial masking is not as severe, and the patient is more expressive. The horizontal nystagmus has been reduced. The movements of the limbs are more flexible than before. The tremors in both hands are not as obvious. It is easier for the patient to begin walking and the random small steps are not as obvious. He can turn around faster and requires 5 to 6 steps to completely turn around and the walking gait is more stable. The bilateral rapid rotation test can be done in a more flexible manner. The balancing ability has improved.

Dmitry Martyanov emailto us:


2012-06-13

"Dear Dr. Zhao

From June the 8th , I reduced dosage of the Sinemet . Now I take a ½  of tablet (a half of hour before the main part of medications)   instead of  its ¾  and feel myself quite better.  Although some kind of inv. movements appear, I began to walk the streets more with confidence. Also drive my car without any difficulties.

Yesterday morning  I was pleasantly surprised because could walk some time, during about 20 min., without taking  medication after I awoke.

But I see real perspective to this. My blood pressure is normal, 120/80 in average.
 

Respectfully,

Dmitry Martyanov"


 

 

 

 

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