Mr.Karadi-Amyotrophic Lateral Sclerosis-(UAE)-Posted on August 8th, 2017

Name: Mr. Karadi
Sex: Male
Nationality: UAE
Age: 55Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis (ALS)  2. Type2 diabetes
Date of Admission: March 21th, 2017
Treatment hospital/period: Wu Medical Center/16 days

Before treatment:
The patient felt weakness in his left leg accompanied with muscular atrophy. His condition gradually developed to both leg's weakness and muscle atrophy. A doctor did an examination with head MRI, blood tests, EMG, etc. and he was diagnosed with "amyotrophic lateral sclerosis" but he had no special treatment. The patient's condition gradually spread to the arms. At present he is unable to move his four limbs and has systemic muscle atrophy. He cannot take care of himself and he wants further treatment so he came to our hospital. He has had a history of type 2 diabetes for many years.
His spirit is good, he follows a diabetes diet, sleep, urination and defecation are normal. He has lost 20kg in weight over three years.

Admission PE:
Bp: 139/74mmHg, Hr: 109/min, breathing rate: 19/min, body temperature: 36.6 degrees. Nutrition status is normal with normal physical development. There is no injury or bleeding spots of his skin with no mucosa, no blausucht, slight throat congestion, and his tonsils do not have swelling. Chest development is normal but he mainly depends on abdominal respiration and the chest breathing movement is weaker than normal. The respiratory sounds in both lungs were lower than normal with no dry or moist rales. The heart beat is low with regular cardiac rhythm and  no obvious murmur in the valves. The abdomen was soft and flat  with no masses or tenderness. The liver and spleen were normal, no edema in both lower limbs.

Nervous System Examination:
Patient was alert and his mental status was good, clear speech, the memory, orientation and calculation ability were normal. Both pupils were equal in size and round, diameter of 2.0mm, react well to light and the eyeballs can move freely. Bilateral forehead wrinkle is symmetrical and he can close his eyes powerfully. The bilateral nasolabial groove depth is equal, tongue is in the middle position, there is no tongue muscle atrophy. Showing the teeth, bulging the cheeks, the chewing ability, soft palate lift and swallowing function are all normal. He can move his tongue freely and there is no choking when he was drinking. The head support ability is slightly weakened. The shrug muscle power of both sides is 1 degree, the hands grip force is 0 degrees, muscle power of the arms is 1 degree with low muscle tone, muscle power of the legs is 0 degrees, with low muscle tone. The bilateral biceps reflex, triceps jerk and patellar tendon reflex cannot be induced by examination. The radial periosteal reflex , Achilles tendon reflex and the abdominal reflex cannot be induced by examination. There is moderately severe muscle atrophy of the humeral back muscle group, intercostal muscles, pectoralis major muscle and 4 limbs muscle groups. The palm jerk reflex is negative, sucking reflex of both sides are negative, Hoffmann sign cannot be induced, bilateral Babinski sign cannot be induced. The gross examination of the superficial and deep sensation is normal, finger opposite movement is normal. He cannot perform the fast alternate movement or finger to nose test as normal because of his weakness. He cannot complete the heel-knee-tibia test, the Meningeal irritation sign is negative.

Treatment:
After the admission, he received related examinations and was diagnosed with ALS. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. He undertook rehabilitation training.     

Post-treatment:
After 16 days treatment, his chest breathing movement is enhanced, the muscle power of the four limbs is improved, he can start to rotate his upper arm inside, his finger movement ability is much more flexible, his grip is at level 2 and there is obvious muscle contraction of the legs with muscle power increased to 1 degree. His muscle tension is better.

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