Pinchas Ruchamkin-Amyotrophic Lateral Sclerosis-(Israel)

Name: Pinchas Ruchamkin
Sex: Male
Nationality: Israeli
Age: 60Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hypertension

Before treatment:
The patient felt weakness in his right hand and leg 4 years ago. He also had fasciculation in his arms. One week later his left leg and left arm became weak so he went to a local hospital and was diagnosed with ALS. He took Riluzole 50mg, q12h, but there was no positive effect. He felt pain in his legs 2 years ago, had language problems 1 year ago,  felt weak in his tongue muscle and 2 months ago his voice became lower than normal. He had shortness of breath after speaking and his respiratory rate was faster. For now he is able to walk slowly with someone’s help, is unable to speak clearly, his respiration function is bad but his swallowing function is normal.
His spirit is good, his appetite is bad, he sleeps well. His urination and defecation functions are normal. He has lost 15 kgs.

Admission PE:
Bp: 123/90mmHg, Hr: 76/min, breathing rate: 18/min, body temperature: 36.3 degrees. Nutrition status is good with normal physical development. There is no injury or bleeding spots of his skin and mucosa, no blausucht. There was much oral secretion in his mouth. The chest development is normal, chest movement was fine, the respiratory sounds in both lungs were reduced in the lower lung area and there was no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. The liver and spleen were normal, shifting dullness is negative. The spinal column is normal and there was no edema in either leg.

Nervous System Examination:
Patient was alert and his mental status is good but he has slurred speech. His memory, orientation and calculation abilities 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 is no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, the soft palate could lift, the uvula was in middle, showing the tongue was normal, showing the teeth was normal also and he could bulge the cheek without air leakage. There was obvious muscle atrophy in the shoulder girdle area, arms, thenar muscles and the hands interosseus muscles. His neck was soft, he could turn his head and shrug.  Proximal side muscle power of the arms was 4 degrees, right arm distal side muscle power was 4- degrees, left arm distal side muscle power was 3 degrees, right hand grip force was 3 degrees and left hand grip force was 2 degrees. Muscle power of the legs was 2+ degrees. The 4 limbs muscle tone was slightly higher. Tendon reflex of the arms was active, of the legs was decreased. Bilateral Hoffmann sign and Rossilimo sign were positive, Babinski sign of both sides was negative. Finger to nose test was fine, he can do the fast alternate movement but in a clumsy manner. The patient can only  perform the finger opposite test with 1-2 fingers. He could not do the heel-knee-tibia test because of weakness. The meningeal irritation sign was negative.

Treatment:
After the admission he received related examinations and 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.     

Post-treatment:
After 15 days treatment the patient’s respiration function was improved, his voice was much louder and clearer and his endurance improved. He can raise his arms easier, muscle power of his arms was increased, his fingers can move with much more flexibility and his grip strength was increased. His legs were flexible, the muscle power was increased, the foot can lift much better when he walks and he can now walk for longer.