Ms.Wolf-Amyotrophic Lateral Sclerosis-(Canada)

Name: Ms.Wolf
Sex: Female
Nationality: Canadian
Age: 64Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Sequela of stroke  

Before treatment:
The patient was unable to speak clearly or rapidly 2 years ago so she went to hospital and did a brain CT and the result was normal. She had balance function problems 1 year ago, she walked in an unstable manner and her legs were stiff and it was easy for her to fall down. She had slight swallowing problems 6 months ago and she ate slowly. She went to see a neurologist in Jan. 2017 and she did some tests and was diagnosed with LAS.
Her spirit is bad, her sleep is good, she defecates once in two days, she urinates many times a day and she lost 7 kgs.

Admission PE:
Bp: 145/79mmHg, Hr: 86/min, breathing rate: 19/min, body temperature: 36.2 degrees. Nutrition status is normal with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion and her tonsils do not have swelling. The respiratory sounds in both lungs were clear 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 soft, with no masses or tenderness.  The liver and spleen were normal, there was no edema in both lower limbs.

Nervous System Examination:
Patient was alert and mental status was weak. Speech was not very clear, her orientation ability, memory and calculation ability were normal. Both pupils were equal in size and round, diameter of 3 mm, react well to light and the eyeballs can move freely. There was no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, she could close eyes powerfully, she could bulge the cheek but with some air leakage. She could make the tongue extend out as normal, there was mild tongue muscle atrophy, no fibrillation. The tongue could move but was not very flexible and could not press against the cheek and isthmus powerfully. Showing the teeth was normal, the bilateral soft palate could lift as normal, the uvula was turned to right side and she had slight difficulty when she took food. There was no choking when she was drinking water. The pharyngeal reflex was normal. She could hold her head up and shrug powerfully. The muscle power of the 4 limbs was 5 degrees, grip force was 5 degrees, muscle tone and tendon reflex of all 4 limbs were normal. Bilateral ankle jerk was normal, ankle clonus was negative. Abdominal reflex was normal. Bilateral palm-jaw reflex was negative, sucking reflex was negative. Hoffmann sign of both sides were positive; Rossilimo sign of both sides were positive. Bilateral Babinski sign were positive. Sensory examination was normal by gross test, finger to nose test and fast alternate movement were done slowly, especially the left arm. Finger opposite movement was normal. Her heel-knee-tibia test was less stable or accurate, especially the right leg. The Romberg's sign was positive, she could not stand on one leg as normal, the meningeal irritation sign was negative.

After the admission, she received related examinations and was diagnosed with Amyotrophic Lateral Sclerosis. 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.     

After 14 days treatment she could perform the support movement with her hands, the speech and swallowing function got better, the uvula was in middle, she could bulge the cheek more powerfully than before and the air leak reduced. The tongue muscles could move with much more flexibility, her balance was improved, she could walk much easier and she could stand on one leg better than before.

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