Mohammad Sarwar Fraz-Amyotrophic Lateral Sclerosis-(Norway)-Posted on May 9th, 2017

Name: Mohammad Sarwar Fraz
Sex: Male
Nationality: Norwegian
Age: 69Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis 2. Hypertension 3. Arrhythmia II degrees of A-V block
Date of Admission: October 19th, 2016
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
Mohammad Sarwar Fraz’s left thumb and index finger were showing weakness 3 years ago. This condition progressed slowly but when his left hand became weaker he went to a local hospital. The doctors thought it may be cervical vertebra disease. His disease progressed rapidly, his four limbs were weak and he had muscular atrophy. He was diagnosed with Amyotrophic Lateral Sclerosis in August 2015 and the doctor prescribed Riluzole and Digoxin. Both of the medicines made no improvement. At present, his left side limbs are weak. He is unable to move his left arm but he is able to walk slowly for a short distance.. His respiration function is not good. He wanted a better life so he came to our hospital.
His spirit, sleep, diet, bladder and bowel actions are all normal. He has had hypertension for many years.

Admission PE:
Bp: 145/92mmHg, Hr: 68/min, breathing rate: 19/mim, body temperature: 36.6 degrees, height: 163cm, weight: 64kg. Nutrition status is normal and there is normal physical development. There is no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion, and his tonsils do not have swelling. Chest development is normal, thoracic mobility abated, the respiratory sounds in both lungs are clear and there is no dry or moist rales. The heart beat is powerful with arrhythmia and with no obvious murmur in the valves. The abdomen is flat, with no masses or tenderness. His liver and spleen are normal with no pain in the stomach. There is no edema in either leg.

Nervous System Examination:
Patient is alert and his spirit is good with clear speech. His memory, orientation and calculation ability are normal . Both pupils are equal in size and round, diameter of 3mm, react well to light and  eyeballs can move freely. There is no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, his tongue is in the middle but with mild tongue muscle atrophy. Showing of the teeth is normal. Patient can bulge his cheeks strongly and his chewing ability is good. The soft palate can lift strongly and the patient can close his eyes as normal. Bilateral supraspinatus, infraspinatus muscles, arm muscles, thenar muscles,  hypothenar muscles and interosseous muscles in both hands show atrophy and on the left side this is more obvious. His neck muscles are soft, he can move his head freely but the left side shrug is weak. Proximal muscle strength of the left arm is at level 2, distal muscle strength is at level 1 +, his left hand grip strength is at level 0. Only the thumb, ring finger and little finger can move mildly. His right arm muscle strength is at level 4, the right hand grip strength is at level 4. The left leg muscle strength is at level 3 +, the right side  leg muscle strength is at level 5. Bilateral arm muscle tension is decreased, bilateral leg muscle tension is basically normal. Ankle clonus is negative. The bilateral bicipital tendon reflex and radial periosteal reflex are not elicited. The patella tendon reflex of the left side and Achilles tendon reflex are not elicited. The patella tendon reflex of the right side and Achilles tendon reflex abate. Bilateral palm jaw reflex are negative. Hoffmann sign of both sides are negative, Rossilimo sign of both sides are negative and the Babinski sign is negative. His left hand cannot finish the finger to nose test or the fast alternative test and finger to finger test because of the reduced muscle force. His right hand can finish the finger to nose test and the fast alternative test accurately but the finger to finger test is poor, and the little finger cannot finish. Bilateral heel-knee-tibia test are basically normal. Meningeal irritation sign is negative.

After the admission he received related examinations and was diagnosed with 1. Amyotrophic Lateral Sclerosis. 2. Hypertension 3. Arrhythmia II degrees of A-V block. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged motor nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. This was done along with rehabilitation training.     

After 15 days of treatment, his blood pressure was in good control. His muscle force improved more than before with the muscle force of the left arm increased by 3 degrees. The five fingers of the left hand can now move and the active extent has increased. The muscle force of the right arm increased, his right hand grip strength was at level 5-, the right side finger to finger test was better than before and the little finger could now finish the finger to finger test.

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