Ryan Harman-Amyotrophic lateral sclerosis-(UK)

Name: Ryan Harman
Sex: Male
Country: UK
Age:34 years
Diagnosis: Amyotrophic lateral sclerosis
Date:August 12, 2014

Before treatment:
         The patient suffered from weakness and fasciculation of the left upper limb without obvious inducement 2 years ago. Then the patient's right upper limb suffered from weakness and fasciculation. He was diagnosed with amyotrophic lateral sclerosis. The patient received Amitriptyline and Riluzole for treatment. The patient suffered from weakness and muscle atrophy of both lower limbs 9 months ago. The disease aggravated gradually. His gait was slow. His speech was slow and articulation was unclear. Before the treatment, the patient suffered from weakness of both upper limbs. He had difficulty with raising arms. The grasp ability of hands was weak. His daily life activity was declined gradually. He was unable to wear or take off clothes. He couldn't take food, brush teeth or wash face by himself. The patient had no obvious breathing difficulty. He had swallow difficulty when he swallow big food. There was no anesthesia or allergy. For further treatment, the patient came to our hospital.

       From the onset of disease, the patient's mood was stable. His diet and sleep was stable. His urine and defecation were regular. His weight had no obvious change. There was no genetic disorders.

Admission PE:
       Bp: 125/89mmHg; Hr: 95/min, temperature 36.2 deg. Br: 20/min. The patient's development and nutrition were normal. The body type was normal. His skin and mucosa were normal, with no yellow stains or petechia. There was no congestion in pharynx. The respiratory sounds in both lungs were clear, with no rales. The heart sound was strong and the rhythm of his heartbeat was normal, with no obvious murmur in the valves. His abdomen was soft, with no pressing pain or rebound tenderness in the abdomen. The liver or spleen were not enlarged. There was no swelling in both lower limbs.

Nervous System Examination: 
       Ryan Harman was alert and his spirit was good. His speech was slow. He had dysarthria. His memory, calculation abilities and orientation were all normal. Both pupils were equal in size, the diameter was 3mms. Both eyeballs could move flexibly and the pupils reacted normally to light stimulus. The forehead wrinkle pattern was symmetrical. He was able to close his eyes with ease. The bilateral nasolabial sulcus was equal in depth. The tongue was at the center of his oral cavity. The teeth was shown without deflection. There was mild atrophy in tongue and the tongue had fibrillation. The movement of tongue was flexible to each side.He had weak muscle to raise his soft palate. The uvula was in the center of oral cavity. There was no air leakage when he drummed his cheeks. His neck was soft. He had strong muscle strength to turn his head and shrug his shoulders. The muscle strength of left upper limb's near-end was at level 4. The muscle strength of left upper limb's far-end was at level 3. The muscle strength of right upper limb's near-end was at level 4. The muscle strength of right upper limb's far-end was at level 3+. The muscle strength of both lower limbs was at level 4. The muscle tone of both upper limbs decreased. The muscle tone of both lower limbs increased slightly. The biceps reflex and triceps reflex were weakened. The knee reflex was active. The radioperiosteal reflex and Achilles reflex were normal. There was severe muscle atrophy in bilateral (hand) muscles of fingers, thenar muscles, both upper limbs' muscle group, bilateral supraspinatus and infraspinatus. The abdominal reflexes was normal. Bilateral palm jaw reflex was negative. The sucking reflex was negative. Bilateral Hoffmann sign was negative. Bilateral Babinski sign was positive. The deep sensation and shallow sensation, using loose measures, were normal. He was unable to finish the finger-to-nose test or finger coordinate movement test. He did the rapid rotation test in a slow manner. He did the heel-knee-shin test in an unstable manner. There were no signs of meningeal irritation.

Treatment: 
        We initially gave Ryan Harman a complete examination. The patient received treatment for nerve regeneration and to activate stem cells in vivo. He received treatment to improve his blood circulation in order to increase the blood supply to the damaged neurons and to nourish them. He also received treatment for nerve regeneration and protection of organ function. At the same time, he received Non-invasive ventilator for breath. This was accompanied by daily physical rehabilitation training.

Post treatment:
       The patient has better tolerance to do exercise. The muscle volume of upper limbs' near-end has increased. The muscle strength of four limbs has improved. The muscle strength to shrug shoulders has increased. The muscle strength of both upper limbs has increased. The muscle strength of left upper limb’s near-end is at level 4. The muscle strength of left upper limb's far-end is alt level 3+. The muscle strength of right upper limb's near-end is at level 4. The muscle strength of right upper limb's far-end is at level 3+. The muscle strength of both lower limbs is at level 5-. The gait is stable, with no obvious shaking. The limp of left lower limb has alleviated obviously.

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Date: 2015-3-27

His Motor Nurons disease seems to have come to a standstill he can't walk on his own and he can't pick things up but the specialist is very pleased with his progress he has oxygen for an hour each day at present.