Fazlur Khan-Amyotrophic Lateral Sclerosis-(USA)

Name: Fazlur Khan
Sex: Male
Nationality: USA
Age: 63Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS)  2. Hypertension 2 degree

Before treatment:
1 year ago the patient’s athletic endurance decreased and he felt fatigue. Six  months ago he had lost his speech and had chewing and swallowing difficulties. The condition progressively developed and he was diagnosed with "amyotrophic lateral sclerosis" 2 months ago in the USA. He began to take "Riluzole ". At present he has poor endurance with exercise but his limb movement is flexible. He has unclear speech, chewing difficulties, difficulty swallowing and has choking. He wants further treatment so he came to our hospital.
His spirit is good, he can eat only small and soft food, drinking water needs to have thickeners added, his sleep, urination and defecation abilities are all normal. He has lost 10Kg weight.

Admission PE:
Bp: 146/83mmHg, Hr: 63/min, breathing rate:21/min, body temperature: 36.7 degrees. Height: 158cm, weight: 57Kg.  There is normal physical development and the nutrition status is good. There is no injury or bleeding spots of his skin and mucosa, there is a 15cm surgery scar on the knee, no congestion of the throat and no tonsil swelling. Chest development is normal, the lungs breathing was clear with no rales. The heart beat was powerful with regular cardiac rhythm, there is blowing murmur in the aortic valve area. The abdomen was soft and flat with no masses or tenderness. His liver and spleen were normal, shifting dullness is negative, spinal column was normal and there was no edema in the legs.

Nervous System Examination:
Patient was alert, mental status was good and his memory, calculation and orientation ability are normal. Both pupils were equal in size, round with a diameter of 3.0 mm, react well to light and with no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical. He can extend the tongue to the lip on the sides and had tongue muscle atrophy with fibrillation. The tongue movement ability is poor and cannot touch the cheek powerfully, showing teeth is normal. Patient can bulge the cheek but with air leakage, chewing ability is weak, the soft palate cannot lift powerfully, he can close eyes powerfully. Patient does not have obvious muscle atrophy, his neck is soft and he can turn his head and shrug as normal. Muscle power of the arms is 5 degrees, of the legs is 5 degrees, the grip force of both hands is 5 degrees. Muscle tone of all 4 limbs is normal, the ankle clonus is negative. Bilateral biceps reflex, radial periosteal reflex and patellar tendon reflex are normal. The Achilles tendon reflex cannot be induced by examination, the bilateral Palm-jerk reflex is positive, the Hoffmann sign of both sides is negative; the Babinski sign of both sides is negative. Performance of the fast alternate movement, the finger to nose test, finger opposite movement and the heel-knee-tibia test are basically normal. The meningeal irritation sign is negative.

After the admission he received related examinations and got a clear diagnosis. He received 3 times nerve regeneration treatment to repair his damaged nerves, replace dead nerves, nourish nerves, regulate his immune system and improve blood circulation. He also undertook rehabilitation training.     

After 14 days treatment his endurance improved, he can speak much more clearly, the swallowing difficulty alleviated, his choking reduced when he drank and he can now  drink water slowly.

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