Antony Granville-Motor Neuron Disease-(UK)
Name: Antony Granville
Sex: Male
Nationality: UK
Age: 43Y
Diagnosis: 1. Motor Neuron Disease 2. Hyperlipemia
Discharge Date: 2019/06/08
Before treatment:
Two years ago the patient had no inducement for limb muscle tremor followed by right foot dropping along with walking instability. One year ago he went to the hospital and was diagnosed with "motor neuron disease". The doctor did not give any special treatment. After that the patient had right arm muscle weakness and muscle atrophy. The condition was aggravated, gradually spread to the left limb and now he has four-limb motor dysfunction. 6 to 8 weeks ago he had dysphagia and respiratory dysfunction, occasional dyspnea during sleeping at night and he needs walking aids.
His spirit, sleep, urination and defecation functions are normal.
Admission PE:
Bp: 133/86mmHg, pulse rate: 74/min, breathing rate 20/min. Height 182cm, weight 95kg, body temperature: 36 degrees. The patient has good nutrition status with normal physical development. There was no ecchymosis of the skin or mucosa, no congestion of the throat, no swelling of the tonsils, a symmetrical chest, clear respiratory sounds of both lungs with no dry or moist rales were heard. There is regular heart sounds, regular heart rhythm, no obvious murmur heard in the valves, a soft abdomen, no tenderness or masses, normal liver and spleen and no edema of the legs.
Nervous System Examination:
He is alert, has good spirit and clear speech with normal memory, calculation and orientation abilities. Both pupils were round and equal in size, a diameter of 3 mm, react sensitively to light, have free eyeball movement and no nystagmus. He has a symmetrical forehead wrinkle and nasolabial fold, strong eye-closing ability and normal cheek-bulging. His tongue is in the middle when extended, there is no tongue muscle fasciculation, flexible tongue muscle movement, strong soft palate lifting bilaterally, strong neck-turning and he can shrug strongly. Muscle power of both arms was 5-, right gripping power was 4-, left gripping power 4. Muscle power of the legs was 4-. There was normal muscle tone of all 4 limbs. The patient had severe muscle atrophy in the biceps, triceps, deltoid, ulnar muscle groups, hypothenar and thenar, interphalangeal muscle groups, quadriceps and gastrocnemius. There was active tendon reflexes of the arms, normal knee tendon reflex, negative Hoffmann, Rossolimo and Babinski signs bilaterally. There was normal deep and shallow sensation by gross examination, normal finger to nose and fast alternate tests bilaterally. The finger to finger test on the left side was normal and only the thumb to index finger was done on the right side. He displayed a normal heel-knee-tibia test result bilaterally and a negative meningeal irritation sign.
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 respiratory function was improved. SAT was 98%. The muscle power of the arms was increased, his right gripping power got stronger (about 4+) and his legs got stronger (about 4). He can now raise his legs easier and walk better.
