Ms.Seed-Motor Neuron Disease-(Pakistan)

Name: Ms.Seed
Sex: Female
Nationality: Pakistani
Age: 50Y
Diagnosis: Motor Neuron Disease(MND)

Before treatment:
The patient was unable to speak clearly 2 years ago then her condition got worse day by day. She couldn’t chew or swallow food and she had muscle weakness in her four limbs 1 year ago with myotonia and the gradual loss of her motor functions. She did blood tests, brain CT, brain MRI and EEG, EMG and other tests and she was diagnosed with MND. At present she has myotonia, is unable to turn over, sit up, stand or walk and she needs help to dress and to eat. It is hard for her to chew, speak or swallow food.
Her spirit is good, she has  a liquid diet, has normal sleep, urination and defecation functions and she has lost around 10-15 kgs weight.

Admission PE:
Bp: 136/84mmHg, Hr: 59/min, breathing rate: 19/min, body temperature: 36.5 degrees. She has normal physical development and nutrition status was normal. There is no injury or bleeding spots of her skin and mucosa. Chest develop was sound. The respiratory sounds in both lungs were weak with no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was slightly bulging and soft with no masses or tenderness.  The liver and spleen were normal. The shifting dullness was negative, spinal column was normal. There was no edema of the legs.

Nervous System Examination:
Patient was alert and her mental status was good. She could not speak but the memory orientation and calculation abilities were normal . Both pupils were equal in size and round, diameter of 2.5mm, react well to light and the eyeballs can move freely. Bilateral forehead wrinkle is symmetrical, she could not make her tongue extend out, there was no tongue muscle atrophy, she could not move her tongue freely but showing the teeth was normal. She could not bulge the cheek, chewing ability was weak, the soft palate could not lift, pharyngeal reflex was weak, she could close her eyes powerfully. There was no obvious muscle atrophy on the 4 limbs, her neck was soft, she could not turn head as normal or shrug. The muscle power of the arms were 3 degrees, the legs were 2- degrees. Muscle tone of the 4 limbs was increased. Left ankle clonus was positive, right side was negative. Tendon reflex of all 4 limbs were hyperactive. Bilateral palm-jaw reflex were positive. Hoffmann sign of both sides were positive, Babinski sign of both sides were positive. She could perform the finger opposite movement, finger to nose test and fast alternate movement but in a slow and clumsy manner. The Heel-knee-tibia test could not performed, the meningeal irritation sign was negative.

Treatment:
After the admission, she received related examinations and was diagnosed with MND. She received 3 times nerve regeneration treatment to repair her damaged nerves, replace dead nerves, nourish nerves, regulate her immune system and improve blood circulation. This was done  with rehabilitation training.     

Post-treatment:
After 14 days treatment her blood potassium level was normal, the blood pressure was stable, the breathing function improved, her blood oxygen improved to 96-99% and the muscle tone of the four limbs decreased.