Abdullah Al Ghamdi-Amyotrophic Lateral Sclerosis-(Saudi Arabia)-Posted on Feb.24th, 2017

Name: Abdullah Al Ghamdi
Sex: Male
Nationality: Saudi Arabian
Age: 40Y
Diagnoses: 1. Amyotrophic Lateral Sclerosis 
Date of Admission: Sept. 10th, 2016
Treatment hospital/period: Wu Medical Center/15days

Before treatment:
Abdullah felt weakness in his right hand and arm, he went to local hospital and did some tests included EMG, he was diagnosed with Amyotrophic Lateral Sclerosis, 7 months later, his left leg and right leg were weakness, too. 5 months before, he had upper limbs and thigh’s fasciculation. He began to take Riluzole 3 months before, but the effect was not good. His left arm was weakness 2 months before, his disease became worse and worse. At present, he is able to walk slowly by himself, his gait is abnormal and it is easy for him to feel tired. His daily life is affected. He wanted a better life so he came to our hospital.
His spirit and sleep are good, his diet, urination and defecation are all good.

Admission PE:
Bp: 118/69mmHg.Pulse: 80/min. Br: 19/min. Temperature: 36.1 degrees. Height 170cm. Weight: 90Kg.Oxyhemoglobin saturation of finger tip: 95-96%.His body type and nutritional situation were normal. There were no yellow stains or petechia on his skin or mucous. The color of his lips was normal. There was no pharyngeal congestion. The tonsils were not enlarged. His bony thorax was symmetrical. The respiratory sounds in both lungs were clear, with no dry or moist rales. There was no precordial bulge. The rhythm of the heartbeats was strong and regular. Heart rate: 80/min. There was no obvious murmur in valves. The abdomen was enlarged with no pressing pain or rebound tenderness or masses. The liver and spleen were normal under palpate touch. The shifting dullness was negative. The physiological curvature of spinal was normal. There was no edema in both lower limbs.

Nervous System Examination:
Patient was alert and his spirit was good. He spoke clearly. 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 responses to light stimuli. Both eyeballs could move freely with no nystagmus. The nasolabial fold and forehead wrinkle pattern were symmetrical. His tongue was centered in theoral cavity. The muscle of tongue had mild atrophy. There was no tooth deflection. He could touch his cheeks with his tongue normally. He was able to blow his cheeks and chew easily. The muscle strength to elevating soft palates was weak. He could close his eyes easily. His neck was soft, and the muscle strength of turning his neck and shrugging shoulders was strong. The grip strength of left hand was level 4-; right hand level 0 and only thumb and little finger showed mild movement. Left arm adduction strength was level 3+, abduction strength was level 3-. Right arm adduction strength was 3-, abduction strength was level 2. Muscle strength of legs was level 2+. Muscle tone of limbs was normal. Tendon reflex of left arm was normal; tendon reflex of right arm cannot be elicited. Tendon reflex of legs was active. Right side Hoffmann sign was positive. Bilateral Rossilimo sign was positive. Right side Babinski sign was positive. Right hand finger-to-nose test, rapid rotation test, finger-to-finger test cannot be performed. Left hand finger-to-nose test and finger-to-finger test were performed normally, but rapid rotation test was performed in a clumsy way. Knee-shin-heel test of legs were performed normally. The meningeal irritation was negative.

Treatment:
Abdullah was confirmed with the diagnosis of amyotrophic lateral sclerosis. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his nerves and replace the dead nerves with new injected stem cells, active stem cells in his body, improve his blood circulation and nourish neurons. This was accompanied with rehabilitation.
     
Post-treatment:
After 15 days of treatment, the oxyhemoglobin saturation of fingertip was 97-98%. Musthe respiratory sound of lungs was clearer than before. The fasciculations diminish. Middle finger and ring finger had mild but confirmed movement. Other fingers and wrist and metacarpophalangeal joints move more flexible. The pain of passive movement for right palm lowered down. Muscle strength of right arms increases half a level. Muscle strength of legs increased 1 level. Legs were able to move away the surface of bed. His energy and spirit are all improved, he walks longer and his gait is better improved.

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