Mr. Aska-Amyotrophic Lateral Sclerosis-(Canada)

Name: Mr. Aska
Sex: Male
Nationality: Canadian
Age: 34Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)  

Before treatment:
The patient’s left toes were numb and weak in November 2014. His condition got worse and he also had  muscle atrophy so he went to hospital in in the Spring of 2015. He did some treatments but his condition was not improved and 1 year after he felt weakness in his left hand and he was unable to grasp objects. He went to hospital in Moscow and was diagnosed with ALS. His condition became even worse although he took some medicines to control it.  3 months ago he was unable to speak clearly or loud, he choked when he was drinking.
His spirit was bad, his sleep and diet are normal. His urination and defecation functions are normal. He had lost 7 kgs in weight.

Admission PE:
Bp: 125/87mmHg, Hr: 84/min, breathing rate: 19/min, body temperature: 36.7 degrees. Height: 187cm, weight: 60Kg. Saturation oxygen: 96%. N
He had normal physical development and the nutrition status is good but he is a little thin. There is no injury or bleeding spots of his skin and mucosa but has congestion of the posterior pharyngeal wall. Left tonsil is swelling. Chest development is normal with normal movement when he is breathing. The lungs breathing sounds was clear with  no rales, The heart beat was powerful with regular cardiac rhythm and no murmurs. The abdomen was soft, with no masses or tenderness. His liver and spleen were normal, there was no pitting edema in the feet.

Nervous System Examination:
Patient was alert with clear speech but his mental status was weak. His memory, calculation and orientation abilities are normal. Both pupils were equal in size and round, diameter of 3.5mm, react well to light and with horizontal nystagmus. The bilateral forehead wrinkle and nasolabial groove is symmetrical. He is able to close his eyes powerfully, can’t bulge the cheek powerfully,  can make tongue extend out as normal and there is no tongue muscle atrophy. The muscle power of touching isthmus and pars palatalis are weak. Showing teeth is normal. The bilateral soft palate can lift as normal. Pharyngeal reflex is weak and sometimes he chokes when drinking. He can raise his head, shrug shoulders and turn the neck powerfully. The muscle power of  the arms is 5-, grip is 3+, the muscle power of the legs is 4-. There is obvious muscular atrophy in the shoulder girdle, four limbs, thenar, hypothenar and interosseous muscles. He also has fasciculation and the muscle tension of the four limbs is normal. Muscle tone of the arms is active but the legs are  lower. The ankle reflex is lower, ankle-clonus is negative, abdominal reflexes were not elicited. Bilateral Palm-jerk reflex is negative, sucking reflex is negative. Hoffmann sign of both sides is positive, the Rossilimo sign of both sides is positive. Bilateral Babinski sign is positive. His deep and superficial sensation are normal. Patient can perform the finger to nose test, fast alternate movement and finger opposite movement stable but he can not finish the Heel-knee-tibia test well because of the weakness. The meningeal irritation sign is negative.

After the admission, he received related examinations and was diagnosed with Amyotrophic Lateral Sclerosis and diabetes. 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. This was done with rehabilitation training.     

After 15 days treatment his breathing and swallowing functions are improved, the finger tips blood oxygen concentration is maintained around 97-99%. The muscle power of his four limbs and grip strength improved. Muscle power of the arms is at level 5-, the grip is 5-. The muscle power of the right leg is at level 4, left leg is at level 4+.

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