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Mitochondrial Myopathy Case Study

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Chief Complaint
Mitochondrial myopathy.

History
Patient is a 60-year-old right-handed white male who states that he was diagnosed as having a mitochondrial myopathy in 2010. At that time, he had had a couple years of slowly worsening shoulder and neck weakness and atrophy. One morning, he woke up and was unable to abduct his arms. He went to a physician at Winnipeg General Hospital in Canada. He diagnosed him as possibly having a form of muscular dystrophy. A muscle biopsy was done and revealed a mitochondrial myopathy. He did not have any further gene sequencing done, but the muscle biopsy was reviewed by a geneticist. He was educated about the expected course of a mitochondrial myopathy and the lack of any specific treatment. He was put on Coenzyme Q10 and [__clonidine] for two years, but did not notice any change. …show more content…

Medications
Advair, aspirin 81 mg, Pravachol, omeprazole.

Examination
Weight 125 pounds. Height 5' 8". Respirations 12. Pulse 82.

General
He is in no obvious distress.

Mental Status
He is oriented x3, alert, cooperative. Good short-term, long-term and intermediate memory. No aphasia. Normal fund of knowledge. Normal attention and concentration.

Cranial Nerves
Visual fields are full to confrontation. Extraocular muscles intact. PERRLADC. Normal facial symmetry, sensation and movement. Tongue and uvula were midline. Normal auditory acuity. Normal shoulder shrug.

Motor
Was 5/5 throughout except for 4+/5 of the internal and external rotators of both arms. He had significantly decreased muscle mass. Tone was normal.

Sensory
Was intact to primary modalities.

Cerebellar
Revealed good finger-to-nose, heel-to-shin and rapid alternating motion.

Gait
Normal. Negative Romberg.
DTRs
1+ throughout. Toes are downgoing.
Impression
Mitochondrial myopathy. It is unclear which type this is, however, there is no treatment for any of the mitochondrial myopathies. Treatment is symptomatic

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