Moshe Ashkenazi-Amyotrophic Lateral Sclerosis-(Israel)

Name: Moshe Ashkenazi 
Sex: Male
Nationality: Israeli
Age: 63Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hypertension

Before treatment:
Moshe Ashkenazi found his right leg was weak 1 year ago. It was hard to walk, but he was not concerned. Then his left leg and arms became weak. Six months ago his leg functions were bad and he fell over a lot. He went to a local hospital and was diagnosed with ALS. The doctor prescribed Riluzole and he also did rehabilitation training but his disease became worse again. In  the last two months he has been confined to bed. His limbs were stiff and weak, he was unable to move them well and he couldn’t take care of himself. He wants a better life so he came to our hospital.
His appetite and spirit are good but he couldn’t sleep well. His urination function is normal, he uses medicines to help him with defecation once in 2 days. He has had hypertension for many years but it is controlled well.

Admission PE:
Bp: 106/83mmHg; Hr: 113/min. Br: 18/min. Body temperature: 36.2 degrees. His development was normal and he had good nutrition. There were no yellow stains or petechia on the skin or mucous. The thorax was in symmetry. The respiratory sounds in both lungs were clear, with no obvious moist or dry rales. The heart sound was strong and the rhythm of his heartbeat was normal. There was no obvious murmur in the valves. His abdomen was bulging. There was no pressing pain or rebound tenderness with no masses. The liver and spleen were normal. Shifting dullness was negative. There were pitting edema below  his ankles,
Nervous System Examination:
Moshe Ashkenazi was alert and his spirit was good. He had dysarthrosis and 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 and both eyeballs could move freely. There was no nystagmus. The nasolabial fold and forehead wrinkle pattern were symmetrical. His tongue was centered in the oral cavity and the tongue muscle was not atrophied. The teeth were shown without deflection. The flexibility of the tongue muscle was not very good. He was able to do cheek blowing well. His chewing was normal. Both soft palates could be raised and the uvula was normal. His neck was soft,he could turn his neck in a flexible and powerful way but the power of shrugging his shoulders was weak. His bilateral shoulder joint,elbow joints and metacarpophalangeal joints were limited,his elbow joint stayed at a bending position. The muscle power of his arms were level 1+,his hand grip was limited. The general movement ability was limited. The muscle power of his legs were level 1,the muscle tone of his legs was high,especially the abduction. The bending tension was high and the four limbs tendon reflexes were slightly higher than normal. The muscles of the four limbs were moderately atrophied. The bilateral Hoffmann sign was negative. The bilateral Babinski sign was positive. He could not finish the movement of finger to nose test and rapid rotation test. He could only do the thumb to index finger of his right hand and the others could not finish the test. He could not finish the heel-knee-tibia test. The meningeal irritation sign was negative.

After the admission, he was diagnosed with Amyotrophic lateral sclerosis. He received 3 times nerve regeneration treatment to repair his damaged motor nerves, replace dead nerves, nourish nerves and improve blood circulation. This was done with rehabilitation training.     

During 14 days’ treatment his breathing function and heart function was more stable. The muscle tension of his four limbs obviously reduced. The muscle power and movements of his limbs are better. The metacarpophalangeal joints of both hands are more relaxed and the pain of his joints is in remission. The grip power of both hands has reached  level 3-, the muscle power of his legs is 2-. His spirit and energy are increased.

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