Thomas-Amyotrophic Lateral Sclerosis-(French)-Posted on Feb.19th, 2016

Name: Thomas
Sex: Male
Nationality: French
Age: 57 Years
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hyperlipemia
Date of Admission: Jan.14, 2016
Treatment hospital/period: Wu Medical Center/17 days

Before treatment:
The patient went to hospital due to pain in left hip joint and leg in August 2014, he didn't have joint disease, so he went to department of neurology to did MRI and CT, but undiagnosed, he began to have left feet drop, lower limbs weakness. 10 months ago, he had EMG and diagnosed as Amyotrophic Lateral Sclerosis(ALS), so he began to take Riluzole, he lost walk ability, stand ability, turn over ability day by day. He had upper limbs weakness 1 month ago, and it became worse quickly. Now he stays in bed, he is not able to move his upper limbs, his hands could do fine movements, he lost motor function of lower limbs, his voice was lower and weak, he swallows slowly, he had mild breath problems, all of his body had atrophy in different degree. He wanted a better life so he came to our center and diagnosed as Amyotrophic Lateral Sclerosis(ALS).
He lost 20kg in 10 months, sometimes, he is not happy and had bad sleep, his urination and defecation were normal.

Admission PE:
Bp: 124/87mmHg; Hr: 85/min. Br: 25/min. Temperature: 36.3 degree. His body development and nutrition were normal. There was no petechia on skin and mucous. His pharyngeal was not congestion. The tonsil was not enlarged. His thorax was symmetrical and the distensibility was lower. The respiration of both lungs was lower, there was no dry or moist rales. Sat was 93-96%. The rhythm of his heartbeat was normal. Hr: 85/min. There was no obvious murmur in the valves. The abdomen was soft and flat with no pressing pain or rebound tenderness. The liver and spleen were normal. There was no edema on both lower limbs. His dorsal artery of foot was normal, both of his foot pointed to the ground.

Nervous System Examination:
Thomas was alert and his spirit was good. He spoke unclear and low voice. His memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3 mms, both eyes had sensitive response to light stimuli. Both eyeballs could move freely. He didn’t have nystagmus. The nasolabials and forehead wrinkle pattern was symmetrical. He could close his eyes strongly. He could do check blowing and chew strongly.  The tongue was centered in the oral cavity. He didn’t have teeth deflection, the tongue muscle was slight atrophied without tremor. He could move his tongue well. Both soft palates could lift, and the strength was strong. The pharyngeal reflex was weak, he didn’t have difficulty with swallowing. His neck was soft. The muscle strength of raise head was weak, turning over was strongly. The muscle power of shrugging shoulders was at level 4. He had muscular atrophy in sternomastoideus, shoulder girdle, both upper limbs, thenar and hypothenar eminences, metacarpal-phalangeal and lower limbs. He had lower limbs’ fasciculation. The abducent muscle power and extensor muscle power of right upper limb were at level 2. The flexor muscle power was at level 4, the grip was at level 5-. The abducent muscle power and extensor muscle power of left upper limb were at level 2-. The flexor muscle power was at level 4-, the grip was at level 3. The muscle power of both lower limbs was at level 1, the muscle tension of fours limbs was normal. Both side biceps brachii reflex, radial periosteal reflex and triceps brachii reflex were weak, lower limbs’ patella tendon reflex, ankle reflex and abdominal reflex were abnormal. Both side pathological sign was negative. The deep sensation and superficial sensation of four limbs were normal. He could do the finger-to-nose test and rapid rotation test slowly. Right hand did finger to finger test slowly. Left index finger, middle finger did finger to finger test normal. But thumb to ring finger and little finger were hard to do. He couldn’t do heel-knee-tibia test. The meningeal irritation sign was negative.

Treatment:
He received relevant examinations and diagnosed with 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hyperlipemia, so he received 4 times of neural stem cell injection and 4 times of mesenchymal stem cell injection to activate the cells, repair nerves, improve circulation, nourish neurons, and we used non-invasive ventilator for breath. We also gave him daily physical rehabilitation.

Post-treatment:
After 17 days treatment, his breath was better, rest Sat was higher to 96-98%. He spoke better, the muscle power of four limbs was better than before. The grip of right hand was at level 5, left hand was at level 4. The abductor and adductor muscle power added 1 level. He could raise his arms easier in supine position. The muscle power of lower limbs was at level 2. He had less lower limbs’ fasciculation.