Mr.Jacobs-Amyotrophic Lateral Sclerosis-(Australia)

Name: Mr.Jacobs
Sex: Male
Nationality: Australian
Age: 62Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hypertension (1 degree)
Discharge Date: 2018/12/14

Before treatment:
Three years ago the patient felt weakness and pain in his right hand fingers and his daily hand activity was affected. After that he had leg muscle spasms and pain so he used oral vitamins as treatment. Two years ago both arms became weak so he went to the local hospital, did MRI and EMG and other related examinations and he was diagnosed with "amyotrophic lateral sclerosis". He took oral riluzole but with no effect. 18 months ago he coughed when drinking water so he had to eat and drink slowly. A year ago his speech was unclear, the tone of his speech decreased and the speed of his speech slowed down. His balance function decreased obviously and it was easy for him to fall. His respiratory function was also declined. One year ago he came to our hospital for treatment and after the treatment his neurological function was recovered and maintained for one year. In the past three weeks the patient's condition has deteriorated sharply, it was very difficult for him to walk even with a walking aid and he was unable to take care of himself.
His spirit is slightly worse, his sleep, urination and defecation functions are basically normal. He has a poor diet, eats semi-liquid food and has lost 5kg. He has had hypertension for many years.

Admission PE:
Bp: 153/88mmHg, Hr: 78/min, breathing rate: 18/min, body temperature: 36.5 degrees. Height 175cm, weight 70Kg. Nutrition status is good with normal physical development. There was no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion, and his tonsils had not swollen. Chest development was normal, chest movement decreased when he took a breath, the respiratory sounds in both lungs were clear but in lower lungs part were weak, and there were no dry or moist rales. The heart beat was 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. There was moderate pitting edema of the legs, normal dorsalis pedis artery pulse and with a slightly higher skin temperature.

Nervous System Examination:
Patient was alert, had slurred speech, his memory, comprehension and calculation abilities were normal. Both pupils were equal in size and round, diameter of 2.5 mm, the reaction to light was sensitive, no nystagmus and the eyeballs can move freely. The bilateral forehead wrinkle and nasolabial fold were symmetrical, he could make his tongue extend out 1-2 cm but it was skewed to the left side. Showing teeth was normal, he had difficulty bulging his cheeks, chewing ability was weak and he had choking when drinking water. He could take mushy food. The bilateral soft palate could lift and the uvula was in middle. There was obvious muscle atrophy of his bilateral shoulder girdles, arms, thenar muscles and hands interosseus muscles. His head dropped to the right lower side when he sat, his neck was soft and the right side neck turning or shrugging ability was weak. The right arm proximal side muscle power was 3 degrees, distal side muscle power was 3+ degrees. The left arm proximal side muscle power was 4- degrees, distal side muscle power was 4 degrees. The right hand grip force was 3 degrees and the left hand cannot grasp because of wrist injury. Right leg muscle power was 2+ degrees, the left leg muscle power was 3- degrees with obvious feet drop. The 4 limbs muscle tone was normal. 4 limbs tendon reflex were normal, the bilateral Hoffmann sign and Babinski sign were negative, finger to nose test and fast alternate movement were clumsy and he could not perform the finger opposite movement. The Romberg sign was positive, the meningeal irritation sign was negative.

Treatment:
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.   

Post-treatment:
After 14 days treatment his respiration function was improved, he spoke clearer and louder, he could bulge his cheeks better, his swallowing function was improved and he took less time eating. The 4 limbs muscle power increased, his legs can lift much higher and he could now walk with a walking aid.

 

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