Rachelle Maltby-Amyotrophic Lateral Sclerosis-(UK)

Name: Rachelle Maltby
Sex: Female
Nationality: UK
Age: 48Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)

Before treatment:
The patient felt numb in right feet 4 years ago, she couldn’t move three toes of right feet, it was hurt in her right leg when she was running. Her right upper limb became weak in 6 months, she also had facsiculation, she was diagnosed with ALS, 18 months ago, she was unable to walk, 12 months ago, she had swallow problems and speaking problems. At present, she is quadriplegia, she needs help with eatting, washing and wearing. She is unable to speak clear, it is hard for her to swallow food. She has PEG for meals.
Her spirit is normal, she use medicines to sleep. She defecate 2-3 times a week, her diets is normal.

Admission PE:
Bp: 126/83mmHg, Hr: 86/min, breathing rate: 19/min, body temperature: 36.4 degrees. Height: 159cm, weight: 62Kg. Nutrition status is good. There is no injury or bleeding spots of her skin and mucosa, no blausucht, doctors did not see her tonsil and throat. Chest develop is normal, the respiratory sounds in both lower lungs were clear and mildly weak, no dry or moist rales. The heart beat is strong with regular cardiac rhythm, with no obvious murmur in the valves. The abdomen was soft and flat, there was Gastrostomy tube fistula in her left upper belly area, no masses or tenderness. The liver and spleen were normal, shifting dullness was negative, spine column is normal, no edema in below lower limbs.

Nervous System Examination:
Patient was alert and mental status was good, the memory, orientation and calculation ability were normal. Both pupils were equal in size and round, diameter as 3.0 mm, react well to light, eyeballs can move freely, no nystagmus, she could close eyes powerfully. Bilateral forehead wrinkle and nasolabial groove was symmetrical, she can make tongue out to teeth side, tongue muscle movement ability was poor, doctors could not see her soft palate lift condition. She could show teeth as normal. Neck was soft, she could not shrug or turn neck in the right side, left side shrug and turn neck ability were weak. The right upper limb muscle power was 0, the left upper limb proximal side muscle power was 1 degree, distal side muscle power was 1+ degree. Her right hand grip force was 1 degree, there were only 2 fingers could move, the left hand grip force was 2 degree. Her lower limbs muscle power was 0. The upper limbs muscle tone decreased, while lower limbs muscle power increased, her right lower limb ankle conus was positive. 4 limbs tendon reflex were active. Her left side Rossilimo sign and Hoffmann sign were positive; the right side Rossilimo sign and Hoffmann sign were negative. Patient could not perform the finger to nose test, finger opposite movement, fast alternate movement, heel-knee-tibia test because of weakness. The meningeal irritation sign was negative.

After the admission, she received related examinations, 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, with rehabilitation training.     

After 15 days’ treatment, her tongue could move much freely than before, she could make tongue out to lip side, her swallowing function got better. The right hand finger movement was much flexible, she can move 4 fingers except her thumb. The lower limbs muscle power improved, it was around 1+ degree now. the right lower limb muscle tone decreased, ankle clonus disappeared. Her condition was stable.

Send Your Enquiry     Contact Us     Sitemap     Help

Copyright @2014 www.wumedicalcenter.com All rights reserved.