Mr. Easter-Amyotrophic Lateral Sclerosis-(Israel)

Name: Mr. Easter
Sex: Female
Nationality: Israeli
Age: 61Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hypertension (2nd degree)

Before treatment:
The patient was unable to speak clearly 1 year ago and it got worse and worse. Her left limbs became weak and she also had muscle atrophy so she went to local hospital and was diagnosed with ALS. She took Riluzole without any good effect. Her condition got worse quickly. It was hard for her to swallow food 8 months ago, her right leg became weak 7 months ago, her breathing function became weak 6 months ago and it was hard for her to walk. At present, her four limbs are weak, there is muscle atrophy, she needs help to sit up and stand,  is unable to chew or swallow well, eats a liquid diet and she will choke when she is drinking. Her speaking is unclear and she is unable to take care of herself,
Her spirit is good, her sleep is normal. Her urination function is normal, she has constipation, has lost 9kgs weight and she has hypertension.

Admission PE:
Bp: 125/78mmHg, Hr: 61/min, breathing rate: 19/min, body temperature: 36.7 degrees, height 150cm, weight: 55Kg She has normal physical development but was very thin. There was no injury or bleeding spots of her skin and mucosa, no congestion of the throat and no tonsil swelling. Chest development was normal, the chest movement decreased when she was breathing. The breathing sounds of lungs was weaker than normal but with no rales. The heart beat was powerful with regular cardiac rhythm and no murmur in the valve areas. The abdomen was bulging but with no masses or tenderness. Her liver and spleen were normal and there was no edema of the legs.

Nervous System Examination:
Patient was alert, mental status was fine, speech was slurred, memory, calculation and orientation abilities  were normal. Both pupils were equal in size, round, diameter of 3.0 mm, react well to light and with no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical, she could make her tongue extend out to the teeth, there was tongue muscle atrophy, showing the teeth was normal. Tongue muscle movement was limited and unable to touch the cheek, she could not bulge the cheek as normal, chewing ability was weak and the bilateral soft palate could not lift as normal. There was obvious muscle atrophy of the bilateral shoulder girdle, arms, thenar muscles, hands interosseous muscles and legs. Her neck was soft and she could not turn her neck or shrug powerfully. The right arm extensor and flexor muscle power was 4 degrees, left arm extensor and flexor muscle power were 4 – degrees. The left hand grip force was 3 degrees, right hand grip force was 4 degrees, muscle power of the legs was 4- degrees. The muscle tone of the four limbs was normal. Bilateral biceps reflex and radial periosteal reflex were normal, the patellar tendon reflex and Achilles tendon reflex in the legs were active, bilateral palm-jaw reflex was positive. Hoffmann sign of both sides was positive, right side Babinski sign was negative, left side Babinski sign was positive. Patient could not perform the finger to nose test or fast alternate movement in a stable manner, only the left side index finger could perform the finger opposite movement normally and the right side finger opposite movement was normal. She could not perform the heel-knee-tibia test, the meningeal irritation sign was negative.

After the admission she received related examinations and 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 her breathing function improved, the breathing sounds of lower lungs was stronger, the blood oxygen concentration maintained around 95-99%. Her swallowing function was better, the drooling reduced, limbs movement ability showed positive change and her endurance improved. The 4 limbs muscle power increased 20%, she was able to raise her arms easier and the limbs were more flexible. She was able to stand up by herself and she was able to walk by herself for 50 meters.


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