Mr.Mordechai-Amyotrophic Lateral Sclerosis-(Israel)

Name: Mr.Mordechai
Sex: Male
Nationality: Israeli
Age: 34Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)

Before treatment:
The patient had difficulty to move his hands 1 year ago and they were painful, after that. His hands couldn’t perform fine movements such as opening a bottle of water or securing buttons on clothing. In recent days his legs became weaker and he was unable to run so he went to a local hospital and had CT, MRI and EMG tests. He was diagnosed with ALS. At present his arms are weak, he is able to dress himself but slowly. He is able to go up stairs slowly but he is unable to go down the stairs. He wants a better life so he came to our hospital.
His appetite, sleep, urination and defecation patterns are normal. His swallowing function is normal. He has lost 6 KGs in the last year.

Admission PE:
Bp: 123/78mmHg, Hr: 67/min, breathing rate: 20/min, body temperature: 36.5 degrees. The patient has normal physical development and his nutrition status was fine. There is no injury or bleeding spots of his skin and mucosa, no congestion of the throat and no tonsil swelling. Chest development is normal, the lungs breathing sound was clear with no rales, The heart beat was powerful with regular cardiac rhythm and no murmur in the valve areas. The abdomen was soft and flat with no masses or tenderness. His liver and spleen were normal. Shifting dullness was negative, spinal column was normal and there was no edema of the legs.

Nervous System Examination:
Patient was alert, had clear speech and his mental status was fine. His memory, calculation and orientation abilities are normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light and with no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical. He can extend his tongue out, has no tongue muscle atrophy and showing the teeth was normal. His tongue can move freely. He can bulge the cheeks and chew as normal. The bilateral soft palate could lift as normal and the uvula was in middle. His neck was soft and he could turn his head with flexibility. There was obvious muscle atrophy of the hands interosseus, thenar, supraspinatus and deltoid muscles. The 4 limbs muscle volume was poor. His abductor muscle power in the arms was 3 + degrees, adductor muscle power were 4 degrees, both hands grip force was 3 degrees. His leg muscle power was 5- degrees. The muscle tone of the arms was increased slightly, leg muscle tone was normal. The tendon reflex of the arms were active and the  tendon reflex of the legs was normal. His bilateral ankle clonus were negative. Bilateral Hoffmann sign were negative, the palm-jaw reflex of both sides were negative. The Babinski sign of both sides were negative. The finger to nose tests were stable, his hands fast alternate movement were performed slowly and without coordination. He could perform the right hand finger opposite movement slowly while his left hand little finger could not do that movement. The bilateral heel-knee-tibia test was stable and accurate. The meningeal irritation sign is negative.

After the admission he received related examinations and then 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.     

After 14 days treatment his blood oxygen concentration increased to 95-97%, his movement endurance increased and the  muscle power of the legs had good improvement. His walking gait was much better and  he walked longer. The  muscle power of the arms increased, the grip force increased 1 degree and his fingers could move with much more flexibility. He could now perform the finger opposite movement test.

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