Leslie Stephenson-Amyotrophic Lateral Sclerosis-(USA)

Name: Leslie Stephenson
Sex: Male
Nationality: USA
Age: 50Y
Diagnosis: Amyotrophic Lateral Sclerosis (ALS)
Discharge Date: 2019/0706

Before treatment:
Two years ago (June 2017), the patient developed weakness in the left arm and spasms in the left shoulder. The weakness then gradually aggravated. After various examinations he was diagnosed with "amyotrophic lateral sclerosis" and began drug treatment. It didn't work. The patient's condition continued to worsen,  gradually developing to a lack of power in the right arm and legs, accompanied by limb muscle atrophy and muscle tremor. At present his muscle strength is obviously decreased and he can’t take care of himself because he cannot sit up, stand, walk, eat, bathe and so on.

Admission PE:
Bp: 119/81mmHg, pulse rate: 85/min, breathing rate 30/min, height 183cm, weight 90kg, body temperature: 36.5 degrees, tips blood oxygen saturation: 90-93%. The patient has good nutrition status and normal physical development. There is no ecchymosis of the skin or mucosa, no congestion of the throat and no swelling of the tonsils. He has a symmetrical chest, slightly low respiratory sounds of both lungs, no dry or moist rales heard, regular heart sounds, regular heart rhythm, a heart rate of 85/min and no obvious murmur was heard in valves. He has a soft abdomen, no tenderness and rebound tenderness, normal liver and spleen and no edema of the legs.

Nervous System Examination:
Patient was alert, had good spirit, slurring of his speech, normal memory,  calculation and orientation abilities. Both pupils were round and equal in size, with diameter of 3 mm, reacting sensitively to light with free eyeball movement and no nystagmus. He has a symmetrical forehead wrinkle and nasolabial fold with strong eye-closing. He was weak with cheeks-puffing and there was air leakage. His tongue is in the middle when extended, he has free tongue movement with muscle atrophy. Soft-palate lifting was unremarkable with a slightly right deviation of the uvula. There was slightly weak neck-turning and shrug. Muscle power: proximal ends of both arms 1; distal ends of the arms 3-; bilateral gripping power 1.  Right leg 3-; left leg 3. Normal muscle tone of both arms and increased muscle tone of the legs. There was difficulty with knee-flexing, muscle atrophy of the biceps brachii, triceps brachii, deltoid, supraspinatus, infraspinatus, latissimus dorsi, biceps femoris, and quadriceps femoris. Active tendon reflexes are present in the 4 limbs. Negative Hoffmann and Rossilimo sign bilaterally with a positive Babinski sign bilaterally. Normal deep and shallow sensation by gross examination. Bilateral fast alternating movement, finger to finger test, and finger to finger test cannot be done due to muscle problems. Heel-knee-tibia test cannot be done and the meningeal irritation sign was negative.

After the admission he received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged nerves, replace dead nerves, nourish nerves (ganglioside, nerve growth factors and neurotrophic factors), improve body environment (Edaravone and Riluzole ), regulate his immune system and improve blood circulation This was combined  with rehabilitation training.   

After 14 days treatment his respiratory function got better with blood oxygen saturation now maintained around 95-99%. The uvula almost got back to the middle position. The muscle tone of both legs reduced.and their muscle power got stronger by 10% with the right leg now at grade 3+ and the left leg at grade 4-. There was more flexible plantar and dorsal foot flexion. Muscle power of both arms was increased and it now became easier for him to lift his arms to the chest.

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