Dreval Irina-ALS-(Russia)-Posted on Mar.5th, 2015
Name: Dreval Irina
Sex: Female
Country: Russia
Age: 68 years
Diagnosis: Amyotrophic Lateral Sclerosis (ALS)
Date: Jan. 19th, 2015
Days Admitted to Hospital: 27 days
Before treatment:
Dreval Irina had fallen down for no apparent reason and dislocated her left ankle in May, 2012. She felt down again in August and fractured her ankle. The fractured ankle was immobilized in a plaster cast for 2 months. After the plaster cast was removed, she couldn’t move her left feet flexibly even though she had rehabilitation training. Few months later, she couldn’t move her right lower limb flexibly even though she had rehabilitation training. She broke her left arm in April, 2013. The weakness on her lower limbs became worse; she could hardly walk only with the help of stick in July. After many examinations she was suspected to have” Amyotrophic Lateral Sclerosis”. She had treatment in Israeli and diagnosed as ALS. She took vitamin E, Baclofen and Riluzole and the therapeutic efficacy was not good. She fractured her left ankle again in April, 2014. After the plaster cast was removed after 7 weeks, her motor function rehabilitation training was not good enough. She could only walk 10 meters with a stick. She couldn’t walk or take care of herself in Sept. 2014. She spoke slowly. The movement of her lower limbs even got worse in the last one month. She couldn’t translate on bad. She couldn’t stand, but she could turn over, sit-up and keep it. She could chew; she swallows a little hard and bucked sometimes when drinking. She wants to have a better treatment, so she came to our hospital. She was diagnosed as ALS.
She was in good spirit, her weight was stable, and her sleep was good. Urination and excrement were normal. She lost 7kg weight.
Admission PE:
Bp: 138/89mmHg; Hr: 85/min. BT: 36.7 degree, RP:19/min, she was in good health condition. There was no ecchymosis or petechia on skin. Her pharyngeal was a little congested. The tonsil was normal. There was follicular hyperplasia on the right pharyngeal wall. Her thorax was symmetrical. The respiration of both lungs was clear, without moist rales. The heart sound was strong, and the cardiac rhythm was regular, and there was no obvious murmur in the valves. The abdomen was soft, with no tenderness or rebound tenderness. The liver and spleen were normal. There was pitting edema on both lower limbs. The artery on the dorsum of the foot fluctuated powerful.
Nervous System Examination:
Dreval Irina was alert and she spoke fluently. But she spoke slowly. Her memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3.0mms, both eyeballs could move freely and the pupils reacted normally to light stimulus. No ocular ataxia. The forehead wrinkle pattern was symmetrical. She had strength to close his eyes. Both nasolabials were equal in depth, cheek blowing strength was normal, the tongue was centered in the oral cavity, muscles of tongue were depauperated. The movement of tongue was inflexible. The teeth were normal and shown without deflection. Both soft palates could be lifted, and the strength was strong. She finds it hard to swallow. The muscles of her neck were soft, the muscle strength to look up, turned around and shrug her shoulder was normal. The girdle muscles, sternomastoid muscle, wasting of the thenar and hypothenar and metacarpophalangeal muscle all atrophied. Both her shoulders, scapular area and both hands atrophied heavily. Both her lower limbs were normal. The abductor and flexor muscles were at level 4. The grasp power of hand was at level 4. The extensor, pronation and supination muscle power were at level 5. The muscle power of lower limb was at level 1. The muscle tension of four limbs was lower. Tendon reflex of both upper limbs were active. The patella tendon reflex and ankle reflex of right lower limb was weaker, left side disappeared.
Both sides ankle reflex was negative, abdominal reflexes disappeared. Both palms jaw reflex were positive. Both sides Hoffmann sign and Rossilimo sign were weakly positive. The right side Babinski was positive. The rough depth determination of both sides was normal. Finger-to-nose test, rapid rotation test and finger-to-finger test were normal. Both legs’ heel-knee-tibia test was hard to complete. The meningeal irritation sign was negative. The resting peripheral oxygen saturation was 92-93%.
Treatment:
We diagnosed Dreval Irina as: Amyotrophic Lateral Sclerosis (ALS). She received consummate examination. We proceeded with the treatment to nourish her nerves and improve the blood circulation to increase the blood supply to the damaged neurons. She also received treatment to activate her own neural cells. Continuous positive airway pressure was used to help her breathe. We also gave her daily physical rehabilitation.
Post-treatment:
After the treatment, her condition gradually improved. Her drinking and eating were normal. She could breathe normal. Her four limbs were stronger. Both of her lower limbs were not dropsied. The abductor and flexor muscle power were at level 5-. The grasp power of hand was at level 5-. The extensor, pronation and supination muscle power of both upper limbs were at level 5. The muscle power of left lower limb was at level 2, right was at level 2+. The muscle tension of four limbs was normal. The resting peripheral oxygen saturation was 94-96%.
