Jacqueline Iavarone-Amyotrophic Lateral Sclerosis-(America)-Posted on Feb.27th, 2018

Name: Jacqueline Iavarone
Sex: Female
Nationality: American
Age: 71Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. SLE 3. Psoriasis
Date of Admission: Sept.27th, 2017
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
The patient couldn’t speak clear 1 year ago, 10 months ago she began to have swallow problem, she choked when drinking, so she went to local hospital and diagnosed with ALS, 5 months ago, her upper limbs became weak, she took Riluzole 50mg,q12h, she began to use edaravone for treatment 2 weeks ago. At present, she can’t speak clear, she has swallow problems, sometimes, she chokes, her respiration function is not good. She is able to stand and walk, but clusmy, she wants a better treatment so she comes to our hospital.
She has back pain, her spirit and appetite are good, she sleeps well. Her urination and defecation functions are normal.

Admission PE:
Bp: 127/80mmHg, Hr: 74/min, breathing rate: 19/mim, body temperature: 36 degrees. Height: 166cm, weight: 65Kg. Nutrition status is poor, normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion. There is around 10cm surgery scar in left ankle, she had much oral secretion. Chest develop is normal, the chest movement range was fine when she was breathing, the respiratory sounds in both lower lungs were decreased, no dry or moist rales. The heart beat is strong with regular cardiac rhythm, with no obvious murmur in the valves. The abdomen was soft and plate, with no masses or tenderness. The liver and spleen were normal, shifting dullness was negative, spine column is normal, no edema in below lower limbs, the dorsalis pedis artery pulse was normal.

Nervous System Examination:
Patient was alert and mental status was good, dysarthria, slur speech, only could distinguish few words, the memory, orientation and calculation ability were normal. Both pupils were equal in size and round, diameter as 3.0 mm, react well to light, eyeballs can move freely. Bilateral forehead wrinkle and nasolabial groove was symmetrical, the soft plate could not life well, the uvula was in middle position, she could make tongue out to lip side, tongue muscle atrophy, show teeth was normal. she could bulge cheek with air leak, the chewing ability reduced. There were muscle atrophy in the bilateral shoulders, upper limbs, both thenar muscles and hands interosseous muscles. Neck was soft, she could turn neck and shrug. Muscle power of right upper limb proximal side was 3 degree, of distal side was 5- degree. the left upper limb proximal muscle power was 3 degree, of distal side was 4 degree. the right hand grip force was 5 degree, left hand grip force was 4 degree. muscle power of lower limbs was 4 degree. muscle tone of 4 limbs was normal. 4 limbs tendon reflex were active, bilateral Hoffmann sign was positive, bilateral Rossilimo sign was positive, the Babinski sign of both sides was negative. The finger to nose test, fast alternate movement and finger opposite movement were basically normal. The meningeal irritation sign was negative.

After the admission, she received related examinations, she received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair her damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate her immune system and improve blood circulation, with rehabilitation training.     

After 14 days’ treatment, her back pain reduced, her speech was much clearly, the breathing function got better. Patient tongue muscle could move much flexible and the drooling reduced, she could try to speak much powerfully, the muscle power of her body increased, the upper limbs distal side muscle power reached 4 degree. She could walk longer and better.

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