Avraham Lahav-Amyotrophic Lateral Sclerosis-(Israel)-Updated on Nov.14th, 2017

The second round of treatment:

Name: Avraham Lahav
Amyotrophic Lateral Sclerosis(ALS)
Date of Admission:
July 11th, 2017
Treatment hospital/period:
Wu Medical Center/14days

Before treatment:
The patient had muscular tremor 5 years ago, he didn’t care about it too much, 2-3 months later, his left hand was weakness and accompanied with muscular atrophy, his right upper limb was also affected, so he went to local hospital and did MRI, EMG and other tests, he was diagnosed with ALS 4 years ago, he took Riluzole to treat it without any good effect. 3 years ago, his lower limbs were weakness. At present, he can not speak clear, his respiration function is weak, his muscle power of upper limbs are weak, he is unable to move his limbs or take care of himself. He is unable to walk, stand up or sit up, if someone help him, he can walk slowly for a short time. He wants a better treatment, so he comes to our hospital and diagnosed with ALS.
His spirit, diet and sleep are good, his urination and defecation functions are normal.

Admission PE:
Bp: 130/86mmHg, Hr: 82/min, breathing rate: 20/mim, body temperature: 36.7 degrees. Height: 170cm, weight: 79Kg. Nutrition status is good, normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion. Chest develop is normal, the chest movement reduced when he was breath, the respiratory sounds in both lungs were weaker than normal, no dry or moist rales. The heart beat is strong with regular cardiac rhythm, with no obvious murmur in the valves. The abdomen was soft and mild bulge, with no masses or tenderness. The liver and spleen were normal, shifting dullness was negative, spine column is normal, no edema in lower limbs.

Nervous System Examination:
Patient was alert and mental status was fine, slur speech, the memory, orientation and calculation ability were normal. Both pupils were equal in size and round, diameter as 2.5 mm, react well to light, eyeballs can move freely. Bilateral forehead wrinkle and nasolabial groove is symmetrical, he can make tongue out, tongue muscle atrophy with obvious tremor. He could not show teeth as normal. His tongue could against the cheek weaker than normal, there was air leak when he try to bulge the cheek, chewing ability was good, the bilateral soft plate coul lift powerfully. He could close eyes powerfully. There were muscle atrophy of the both shoulder area, upper limbs, thenar muscles and hands interosseous muscles. Neck was soft, while he could not turn neck or shrug powerfully as normal. Left arm adductor muscle power was 2 degree, abductor muscle power was 1 degree; right upper limb adductor muscle power was 2+ degree, abductor muscle power was 1 degree. Grip force of right hand was 2- degree, of left hand was 0 degree. Muscle power of lower limbs was 3 degree. Muscle tone of upper limbs decreased, both lower limbs muscle tone were normal. Ankle clonus was negative. Left side biceps reflex decreased and right side biceps reflex could not be induced by examination. Bilateral radial periosteal reflex could not be induced by examination. Lower limbs patellar tendon reflex was active, Achilles tendon reflex could not induced, bilateral Palm-jaw reflex was positive; Hoffmann sign of both sides were negative; Babinski of both sides were positive. Finger to nose test, fast alternate movement, finger opposite movement could not performed because of the weakness. Heel-knee-tibia test was not stable or accurate, the meningeal irritation sign is negative.

After the admission, he received related examinations and diagnosed with ALS. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation, with rehabilitation training.     

After 14 days’ treatment, his breathing function got better, his saturation oxygen was 96-98%, his speech was clearer than before, the blood oxygen saturation increased, upper limbs muscle power had increased, the right arm proximal side muscle power improved, and his right thumb had abduction movement again, his lower limbs’ muscle strength was higher than before, and lifting movement of leg was better than before when he was walking. He could walk for longer distance.

The first round of treatment:
Date of Admission: August 25th, 2016
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
Avraham had muscle tremors in his left upper limb without any known causes, 4 years ago, 2-3 months later, his left hand developed weakness and he also had muscular atrophy. His right upper limb was involved, so he went to the local hospital and had an MRI, EMG and other tests done. He was diagnosed with Amyotrophic Lateral Sclerosis 3 years ago. He was prescribed Riluzole but it wasn’t effective. The symptoms become worse. He developed muscle tremors and weakness in the lower limbs 1 year ago.  At present, his limbs are weak and he walks slowly. He wanted a better life, so he came to our hospital.
Avraham was in good spirits. His diet and sleep were good. His urination and bowel movements were normal.

Admission PE:
Bp: 145/90mmHg; Hr: 84/min. Br: 19/min. Temperature: 36.7 degrees. Height:170. Weight:82kg. Avraham has a normal and well-nourished body type. His skin and mucosa had no yellow stains, bleeding points or ecchymosis. His lips had no cyanosis. There was no pharyngeal congestion. The tonsils were not enlarged. His bony thorax was symmetrical and the type was normal. The respiratory sounds in both lungs were clear, without dry or moist rales heard. There was no intumescing of the precordia. His heart rhythm was regular and strong, without obvious murmur in the valves. The abdomen was intumescing slightly with no pressing pain or rebound tenderness. The shifting dullness was negative. His legs were not swollen. The spine is normally developed.   

Nervous System Examination:
Avraham Lahav was alert and he was in good spirits. He was not able to speak clearly. His memory, calculation abilities and orientation were normal. Both pupils were equal in size and round, the diameter was 3 mms. Both eyes had sensitive responses to light stimuli. Both eyeballs could move freely and he had no nystagmus. The nasolabial fold and forehead wrinkle pattern were symmetrical. The tongue was centered in the oral cavity. The muscles of the tongue were slightly atrophied; there was no tooth or mouth deflection. There was some air leakage when the cheeks were expanded.  He chewed powerfully; both soft palates could be raised and were symmetrical. He could close his eyes normally. The bilateral shoulder girdle,muscles of the upper limbs, bilateral muscle of the thenar and hypothenar were atrophied; his neck was soft, the ability of his neck to turn was weak and he wasn’t able to shrug his shoulders strongly. The adduction muscle power of the left upper limb was level 3.  The abductor muscle power was level 2+, the abductor muscle power or the right upper limb was level 3, the adduction muscle power was level 3+, the right hand gripping strength was level 2-,the left hand gripping strength was level 1. The muscle strength of both lower limbs was level 4; the muscle tension of all four limbs was slightly high. The bilateral biceps reflexes were active, the patellar tendon reflexes of both lower limbs were active. The bilateral Hoffmann and Babinski sign were positive. Due to lack of muscle strength he could not finish the finger-to- nose,finger-to-finger or rapid rotation test. The heel-knee-tibia test was normal. The meningeal irritation sign was negative.

Avraham received relevant examinations and was diagnosed with Amyotrophic Lateral Sclerosis and Hypertension level 2 (high risk), he received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged nerves, replace the dead cells with new injected cells, activate the stem cells in his body, regulate his immune system, improve his blood circulation, nourish the neurons and reduce the blood pressure. This was accompanied with rehabilitation therapies.          

After 14 days of treatment, Avraham had more strength in his  upper limbs. The pronation and supination movement range of the upper limbs were increased, the adduction and abduction movements of both thumbs were better than before. The muscle power of the lower limbs was improved, he could walk longer and his mood and energy were improved.

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