An extract from the case record. (12 December 1997. Doctor-orthopedist-..)
...In the early neonatal period had natal asphyxia, subarachnoid hemorrhage;
purulent meningitis, double pneumonia: Dysplasia of the hip joints.
Received treatment in MODOKh: to 6 months -- spacer splint,
to 1 year - Vilensky splint. Was given massage, thermal treatment,
electrophoresis with Ca, P.
Under observation by local neurologist.
Diagnosis: Perinatal encephalopathy, period of rehabilitation.
Infantile cerebral paralysis. Hemiparesis at the left of spastic type, more
evident in lower limb.
Received 3 series of treatment in NTTs PNI (Skvortsov-Osipenko method).
Began to independently walk at age of 1 year 2 months. Gait changed.
Pronounced ataxia. "Drags" left leg. Movements in left hip joint
limited - bends to 50 degrees, swing to 30 degrees.
Left hip shortened by 1 cm.
Active movements not possible in left ankle joint, passive - very limited.
Contracture of left hip joint owing to innate dislocation of left hip.
Aseptic necrosis of the head of the left hip, repair stage.
Contracture of left ankle joint of neurologic genesis.
Received PT, massage, removable splint (for night) for correcting left
Operated on in the city of Tula in the IKR according to V.B. Ulzibat method
on 9 June 1997.
Mptomography of brain 11 November 1995.
-- focal lesion of brain according to demyelinization type process,
hypoplasia of the corpus callosum.
EEG - changes in brain showing rough stimulation of the truncal structures of the brain, formation of an epiactive focus in deep structures of the brain. (before stimulation)
EMG - suprasegmental character of damage. Speed of carrying out pulse
by efferents in N. Tendinous reflexes S=D, caused.
Consultation with assistant Professor Shariborova - thought should be given
to myelodysplasia at the level of the lumbar section of the spinal cord.
EEG of 17 September 1997 -- specific features of epiactivity not discerned.
Examination by neurologist 27 October 1997 (after 3 coursis of treatment
Began to move more freely. Symptoms of ataxia less evident. Sparing gait,
drags left leg, left foot turned inwards.
Tonus of left limbs high, greater in leg. Reflexes S>D.
Speech defects. Girl communicative, quiet.
Examination by orthopedist 10 November 1997
Gait became freer. During walking steps on whole foot. Varus setting of
Mobility of right hip joint complete, left limited: - swinging to 45 degrees,
bending to 150 degrees.
Mobility in knee joints complete. Right ankle joint and foot - N.
Left ankle joint - independent movements within the limits of 5 degrees,
passive movements limited. The foot is passively put in the correct position...
Under observation of mother (summer 1997):
I began to note that the toes of the left foot hardly moved, even at age less than one year. But left leg was like the right in respect of circumference and length.
Treatment in Skvortsov Clinic 3 times with Skvortsov-Osipenko method (Center of Neurologic Infantile Invalidism, Professor Skvortsov).
After treatment the mobility (relaxation) of the hip, ankle and knee joints improved, but after 1-2 months the mobility of the joints worsened (returned to the initial state) in spite of scleromere massage (4-5 times each day), general massage (2-3 times a year). Coordination improved.
2 years old
Retarded development of left leg. Circumference of calf of left leg much less than that of right, leg has a bluish tone. Left leg spastic.
Treatment by method S.-Z. (December 1996) - 7 days.
Result - mobility of ankle and hip joints increased, contracture of knee joint ended. Knee joint normal - full mobility up to present day.
After a month the condition of the ankle and hip joints slightly worsened, but as compared with condition prior to VS-treatment, the joints and muscles substantially more relaxed.
From 2 to 2.5 years old - child did not receive any treatment (on the other hand this is good, the child got a rest). The condition of the hip joint and especially the ankle joint worsened, but anyway was substantially better than prior to BMS.
2.5 years old. Operation in Tula. After the operation the left foot takes on an almost correct (more level) position, the mobility of the hip joint substantially increases (the leg is raised to the head), but when walking the child drags his leg substantially (does not bend the knee) and walks as a whole in a much worse manner than before the operation.
Furthermore, sensitivity of the sole of the left foot is in practice lost, there is no reaction to touching and tickling, cannot stir the foot, cannot stir the toes of the left foot. Cannot sit in a Turkish manner. The foot is stressed, when raised there is an abrupt stop. Free movement of the foot only inwards.