Marc-Amyotrophic Lateral Sclerosis-(Australia)

Name: Marc 
Sex: Male
Nationality: Australian
Age: 67Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)
Discharge Date: 2018/02/20

Before treatment:  
The patient felt pain in his right hand when he used a keyboard 2 years ago and he felt pain in his leg muscles after that. He felt better after he took some vitamin pills but then felt weak in his arms 18 months ago. He was diagnosed with ALS after he did MRI and EMG tests. His condition got worse day by day. He coughed when he drank 1 year ago, he couldn’t speak clearly 9 months ago and  he spoke slowly. His balance function became bad 2 months ago and he fell down a lot. His respiration function then became bad 6 weeks ago. At present he walks with a walking aid and can stand by himself but finds it very difficult. He speaks unclearly and has problems with his swallowing function just eating small pieces of soft food slowly.
His spirit is normal, his sleep, diet, urination and defecation functions are normal. 
  
Admission PE:
Bp: 150/96mmHg, Hr: 68/min, breathing rate: 18/min, body temperature: 36.2 degrees. Height: 175cm, weight: 75.5Kg. Nutrition status is good with normal physical development. There was skin injury on the right arm and bruising on his back waist area with a diameter around 5cm, no blausucht. Chest development was normal while the chest movement range decreased when he was breathing. The respiratory sounds in both lower lungs were weak with no dry or moist rales. The heart beat was strong 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, shifting dullness was negative, spinal column is normal, there is mild edema in the legs, the dorsalis pedis artery pulse was normal.

Nervous System Examination:
Patient was alert and mental status was good with dysarthria and slurred speech. The memory, orientation and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light and the eyeballs can move freely. Bilateral forehead wrinkle and nasolabial groove was symmetrical, he can make his tongue extend out to left side. He could show teeth as normal, could bulge the cheek without air leakage and chewing ability was normal. Bilateral soft palate can lift and the uvula was in middle. There was muscle atrophy in the bilateral shoulders girdle, upper limbs, both thenar muscles and hands interosseous muscles. Neck was soft, he could turn his neck and shrug. Muscle power of the right arm proximal side was 3+ degrees, distal side was 4 degrees. The left arm proximal side muscle power was 4 degrees, distal side was 4+ degrees. The right hand grip force was 4- degrees, the left hand grip force was 4 degrees. The right leg muscle power was 3 degrees, left leg muscle power was 4- degrees. He had obvious feet drop. His 4 limbs muscle tone were normal, left arm tendon reflex was active, of the right leg was decreased. The tendon reflex of the right arm and right leg were basically normal. Bilateral Hoffmann sign was negative, Babinski sign of both sides was negative, patient could perform the finger to nose test normally, right side fast alternate movement was much more clumsy compared with the left side. On his left hand 3 fingers could perform the finger opposite movement and only 1 finger could perform the movement on the right side. His Romberg's sign was positive, the meningeal irritation sign was negative.

Treatment:
After the admission he received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 15 days treatment his speech tone increased and became more clear, his swallowing function improved with less coughing when he drank and he also ate faster. His right arm muscle power increased around 10-20%. His balance got better, the muscle power of his back and legs became better, he can now stand up by himself and walk for 10 meters without assistance.