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Case
Age: 63Yrs.
Sex: Female
Diagnosis: Muscular Dystrophy
Country: India
Date of stem cell therapy done: On 22/03/2010 underwent Autologous bone marrow derived stem cells + intensive Neurorehabilitation (NRRT).
Brief History:
Is a known case of Muscular Dystrophy since 1986. It began with history of slowly progressing weakness of bilateral upper limb with difficulty in lifting her child and overhead activities. Later weakness progressed to bilateral lower limb with history of frequent falls. In 2009, has history of left fracture neck femur and was operated for the same with steel plate fixation. Meanwhile facial muscle weakness also developed.Clinical presentation:
Neurologically, she was hypotonic and hyporeflexic. She had all sensations intact. She has grade 2++ strength in bilateral lower limb and grade 3 in bilateral upper limb with predominantly proximal muscle weakness >> distally. On examination, she was osteoporotic with severe wasting of bilateral upper limb and lower limb muscles. On investigation, EMG reveals primary muscle disease. Functionally, she was dependent on the caregiver for all ADL and wheelchair bound for mobility. On FIM she scores 53.Investigations till date in Ascending Order:
22/9/92: EMG: Generalised primary muscle disorder. Right median sensory neuropathy.7/12/09: Lumbosacral spine: AP and lateral view: minimal changes of lumbar spondylosis at L3, L4 and L5
3/2/2010: EMG : Electrophysiological study is s/o primary muscle disease.
2/3/10: MRI Brain: Multiple tiny chronic ischaemic focii in bilateral frontoparietal subcortical white matter
25/3/10: CPK : 67818.2 (25-200 IU)
5 months post therapy:
1) Her exercise tolerance has improved.2) She is now able to walk with one hand support or holding wall/chair. She was unable to walk pre SCT.
3) She is able to stand with some back support. Pre SCT she was unable to stand.
4) Bilateral hand grip has improved, left more than right.
5) Able to throw ball much better now.
6) She is now able to straighten her right MF. She was unable to do that pre SCT.
7) She is able to break chappati with one hand. Earlier she used to need both hands to break it.
8) She is able to lift up ¾ filled cup (approx 100 ml) upto her mouth easily with left upper extremity and with right upper extremity she requires help of left upper extremity.
9) She is now able to crumple newspaper with both her feet left more than right. Earlier she was unable to do so.
10) She is now able to do pushups which she could not do before.
11) Bed mobility – she is now able to get up in side lying position independently from left side and requires minimal assistance from right side.
12) While walking, she is able to lift her left foot now.
7 months post therapy:
1) Her exercise tolerance has improved.2) She is now able to walk with one hand support or holding wall/chair. She was unable to walk pre SCT.
3) She is able to stand with some back support. Pre SCT she was unable to stand.
4) Bilateral hand grip has improved, left more than right.
5) Able to throw ball much better now.
6) She is now able to straighten her right MF. She was unable to do that pre SCT.
7) She is able to break chappati with one hand. Earlier she used to need both hands to break it.
8) She is able to lift up ¾ filled cup (approx 100 ml) upto her mouth easily with left upper extremity and with right upper extremity she requires help of left upper extremity.
9) She is now able to crumple newspaper with both her feet left more than right. Earlier she was unable to do so.
10) She is now able to do pushups which she could not do before.
11) Bed mobility – she is now able to get up in side lying position independently from left side and requires minimal assistance from right side.
12) While walking, she is able to lift her left foot now.
13) Handwriting has improved than before.
14) Her FIM scores have improved from 53 to 61.
12months post therapy:
1) Able to get up from raised bed independently. Able to sit from standing position independently.2) Able to stand without any support for almost 1 minute.
3) Able to put on upper body dress with minimal assistance. She can put all her buttons including top 2 independently.
4) She is independent for lower body dressing.
5) She is able to brush her teeth independently but unable to gargle.
6) She can tear chappati’s with one hand now. Earlier she required both the hands.
7) She can walk with help of walker to the toilet. She can sit on the commode. She can flush independently.
8) She is now able to stand (slightly resting against the kitchen platform) and able to cut vegetables, roll chappatis and roast it on the tawa, she can also make bhaji, etc. she can stand 45 minutes – 1 hour at a stretch in the kitchen.
She prepares her son’s Dabba, picks up utensils and arranges everything properly in the kitchen.
9) Can’t light lighter but can light match sticks.
10) Can stitch a little like hemming/shortening her nighties, etc.
11) Lip closure much better. Speech much clearer.
12) Can manipulate/maneuver over 1 inch of floor height which was very difficult earlier (video available).
13) She folds the washed clothes
source ; http://www.stemcellsmumbai.com/
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