Saar YardenTabakman-Amyotrophic Lateral Sclerosis-(Israel)

Name: Saar YardenTabakman
Sex: Male
Nationality: Israeli
Age: 40Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)

Before treatment:
The patient had right limb fasciculation in November 2016, his left leg was also involved, he had leg weakness and his body was stiff in the morning. He went to hospital and was diagnosed with ALS. He took Riluzole for two months but he thought the medicine was useless so he stopped using it.
His spirit is good, his diet, sleep, urination and defecation functions are normal.

Admission PE:
Bp: 125/82mmHg, Hr: 72/min, breathing rate:18/min, body temperature: 36.5 degrees. Height: 172.5cm, weight: 93.5Kg.The patient has normal physical development and his nutrition status is good. There is no injury or bleeding spots of his skin and mucosa and no congestion of throat. 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 and bulging, with no masses or tenderness. His liver and spleen were normal, shifting dullness is negative, normal spinal column. There was middle pitting edema in his feet and he had feet drop malformation.

Nervous System Examination:
Patient was alert and his mental status was good. He had clear speech,  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 no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical, he can make tongue extend out as normal, there is no tongue muscle atrophy and showing the  teeth was normal. His tongue can touch the cheek powerfully, he can bulge the cheek powerfully and chewing ability is normal. The bilateral soft palate can lift as normal. Patient can close his eyes powerfully, his neck is soft, he can turn his neck powerfully but shrug ability of both sides is weak. Abductor muscle power of the arms proximal side is 3 degrees,  distal side is 4 degrees. Grip force of both sides is 5- degrees. Muscle power of the legs is 2- degrees. He had feet drop. Muscle tone of the arms is normal but of the legs is lower. Bilateral biceps reflex and radial periosteal reflex are normal. Patellar tendon reflex and Achilles tendon reflex cannot be induced. Bilateral Palm-jerk reflex is negative, Hoffmann sign of both sides is negative, the Rossilimo sign of both sides is negative. Bilateral Babinski sign is neutral. Patient can perform the finger to nose test, fast alternate movement and finger opposite movement stable, he cannot finish the Heel-knee-tibia test because of the weakness. The meningeal irritation sign is negative.

Treatment:
After the admission, he received related examinations and was diagnosed with Amyotrophic Lateral Sclerosis. 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.     

Post-treatment:
After 15 days treatment his endurance improved, he regained the ankle reflex again. Muscle power of the right leg is 2+ degree,  left leg is 2 degrees. The right big toe can perform the dorsal movement.

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