Heather Kerr Fullerton-Motor Neuron Disease-(Canada)

Name: Heather Kerr Fullerton
Sex: Female
Nationality: Canadian
Age: 53Y
Diagnosis: Motor Neuron Disease: primary lateral sclerosis
Discharge Date: 2019/04/15

Before treatment:
The patient had limb weakness, muscle pain and spasms 10 years ago. She went to the local hospital in 2011 and was diagnosed with "motor neuron disease: primary lateral sclerosis.” She did not do any special treatment. The symptoms gradually developed, 4 years ago there began to appear muscle spasms in both legs, stiffness, pain and numbness. Dysphagia began to occur 6 months ago and there was occasional choking and coughing when she was drinking water. Her breathing ability and language ability were basically normal. At present the patient can walk independently, she has weak limbs, there is abnormal feeling in her legs and she occasionally has a choking cough.
Her spirit is good, she sleeps well after taking drugs and her diet is normal. She has long-term constipation and after she takes oral defecation drugs is prone to diarrhea.

Admission PE:
Bp: 138/86mmHg, Hr: 90/min, breathing rate 19/min, body temperature: 36.1 degrees. Height 174cm, weight 89Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion and her tonsils do not have swelling. Chest development was normal, the respiratory sounds in both lungs were clear and there were 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 and there is no edema of the legs.

Nervous System Examination:
Patient was alert, had clear speech and her mental status was fine. Her memory,  calculation and orientation abilities were normal. Both pupils were equal in size and round, diameter of 3 mm, the reaction to light was sensitive, with no nystagmus and her eyeballs can move freely. The bilateral forehead wrinkle and nasolabial fold are symmetrical, showing teeth was normal, she could make her tongue extend out normally, the tongue move freely and it can push against cheek powerfully. Chewing ability was normal, she could bulge her cheeks powerfully and the soft palate can lift normally. She could close her eyes powerfully, her neck was soft and she could turn her neck and shrug powerfully. The arms proximal muscle power was 4- degrees, distal side muscle power was 4 degrees, the abductor muscle power was 3 degrees, the right leg muscle power was 3 degrees, left leg muscle power was 4- degrees. The right hand grip force was 5 degrees, left hand grip force was 5- degrees. The 4 limbs muscle tone was normal, bilateral biceps reflex, radial periosteal reflex and triceps reflex were active and the patellar tendon reflex in the legs was lower than normal. The bilateral Palm-jaw reflex was negative, the Hoffmann sign and Rossilimo sign were negative, bilateral Babinski sign were negative. Hypaesthesia of her legs includes pain, superficial sensation and epicritic sensation. The legs deep sensation nearly disappeared, others sensation were normal. Finger opposite movement was normal, right side fast alternate movement was slightly clumsy, finger to nose test was not very stable, the heel-knee-tibia test was not stable and the meningeal irritation sign was negative.

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

Post-treatment:
After 14 days treatment it was easier for her to swallow food, her 4 limbs muscle power increased 10%, the proximal side muscle power was now around 4 degrees.  She could raise her arms higher and move her hands in a more flexible way and her hands can do fine movement better. The muscle power of her legs was now around 4 degrees, muscle tension was basically normal, she could walk better and longer and the numb feeling of her legs improved. The muscle spasms and pain were significantly reduced and the superficial sensation improved a lot.


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