Finch Lynne-Motor Neuron Disease-(UK)

Name: Finch Lynne
Sex: Female
Nationality: UK
Age: 63Y
Diagnosis: Motor Neuron Disease(MND)
Discharge Date: 2018/07/13

Before treatment:
The patient felt heavy in her legs in September 2016. She also felt weak in the legs combined with pain and stiffness. A few months later her condition got worse, her speech lacked power and she was diagnosed with MND. She felt weak in her fingers 6 months ago, combined with facsiculation and her toes were not flexible. At present she can’t do fine movement well with her hands, she has a low voice and a lot of drooling, her breathing condition is not good, she sleeps in semi-reclining position and she walks with a stick.
Her spirit is not so good, her sleep is normal. Her urination and defecation functions are normal.

Admission PE:
Bp: 129/80mmHg, Hr: 84/min, breathing rate: 18/min, body temperature: 36.0 degrees. Height: 158cm, weight: 65Kg. Patient has normal physical development, there was no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion and no tonsil swelling . Chest development was normal, the chest movement was basically normal when she was breathing and the respiratory sounds in both lungs were clear 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 with no masses or tenderness. The liver and spleen were normal, her right lower leg skin temperature was colder than normal. Shifting dullness was negative and her spinal column was normal with no edema in the legs.

Nervous System Examination:
Patient was alert and her mental status was fine. She had slightly  slurred speech with a lower voice, the memory, orientation and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm, reacted well to light, the eyeballs can move freely and there was no nystagmus. Bilateral forehead wrinkle and nasolabial groove were symmetrical, she could close her eyes powerfully, bulge cheeks with mild air leakage, make her tongue extend out with mild tongue muscle atrophy and jaw tremor. The tongue muscle movement was not as flexible as normal, it could not touch against the cheek powerfully. Showing the teeth was normal. The bilateral soft palate could lift powerfully, the uvula was skewed to the right side. She had some difficulty to swallow but she could take food with normal speed and there was choking when she drank water. Pharyngeal reflex existed while clumsy, patient could raise her head up, shrug and turn her neck powerfully. The muscle power of the arms was 5- degrees, grip force was 4 degrees and the fingers muscle power was 4- degrees, especially the first 3 fingers. The leg muscle power was 4- degrees, she could perform planter flexion movement clumsily and there was obvious muscle atrophy of the leg gastrocnemius muscle, tibialis anterior muscles and hands palm and fingers muscles. The 4 limbs muscle tone and  tendon reflex were normal. Her bilateral ankle reflexes were normal, ankle clonus were negative. Abdominal reflex was normal. Bilateral sucking reflex was negative, the palm-jaw reflex was negative. Bilateral Hoffmann signs were positive, Rossilimo signs were positive, Babinski signs were neutral. The sensory system was normal by gross measure. Patient could perform the finger to nose test and fast alternate movement normally. The finger opposite movement was difficult. The heel-knee-tibia test was not stable and the  meningeal irritation sign was negative.

Treatment:
After the admission she received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) 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 tongue muscle movement was more flexible than before and  her choking reduced. The blood oxygen concentration maintained around 96-98% and her breathing function was much better. Her muscle power improved with the arm muscle power 5 degrees, the hands grip force 5- degrees and the finger muscle power 4+ degrees. The fingers could move in a much more flexible way. The leg muscle power was 4+ degrees, her foot could perform the planter flexion movement much better than before and was much more powerful. She could now walk longer and felt less pain in her body.