Yael Yehudit Danieli-Amyotrophic Lateral Sclerosis-(Israel)

Name: Yael Yehudit Danieli
Sex: Female
Nationality: Israeli
Age: 49Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)

Before treatment:
The patient felt weak in her left leg 3 years ago, she also had fasciculation and foot drop. She did rehabilitation training but there was no improvement. Her right leg became weak 1 year later and her arms were also involved. She choked when she was drinking water 9 months before. She was diagnosed with ALS 4 months ago, her voice became lower and her respiration function became bad. She couldn’t take care of herself at all. For now she could only use her hands to do simple movements, she needs help to dress, eat or wash. She is unable to speak clearly.
Her spirit is good, it is hard for her to breathe or sleep, her urination and defecation functions are normal.

Admission PE:
Bp: 137/73mmHg, Hr: 86/min, breathing rate: 19/min, body temperature: 36.3 degrees. 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 breathing sounds of the upper lungs was clear, the middle and lower part were weaker than normal and there were no rales. The heart beat was powerful with regular cardiac rhythm and no murmur in the valve areas. The abdomen was bulging with  no masses or tenderness. Her 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, mental status was fine, the memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light and have no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical, she could make tongue extend out as normal, showing the teeth was normal, tongue muscle could move freely and the tongue could touch the cheek powerfully. The bilateral soft palate could lift as normal and she could close her eyes powerfully. The neck was soft but the right side neck turning ability and shrug ability were weak whilst the left side could not turn or shrug at all. The arms proximal side muscle power was 1 degree, distal side muscle power was 2 degrees, the left hand grip force was 2+ degrees, right hand grip force was 4- degrees. Muscle power of the legs were 1 degree. There was only slight toe movement and the 4 limbs muscle tone was low. The ankle clonus was negative, 4 limbs tendon reflex could not be induced by examination, the bilateral Rossilimo sign was positive, the bilateral palm-jaw reflex was negative. The Hoffmann sign of both sides was negative, the Babinski sign of both sides was negative, the little fingers could not perform the finger opposite movement, she could not perform the finger to nose test, fast alternate movement or heel-knee-tibia test because of weakness. The meningeal irritation sign was negative.

After the admission 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 her breathing and heart functions were improved. Her respiration rate was 19/min and her heart rate decreased to 65-80/min with the breathing function much better. She now speaks with a much louder voice, her hand grip forced increased with the left hand now 3 degrees and the right hand 4 degrees. The feet could move much more than before and there was obvious muscle contracture of the right thigh.

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