German Roman-Amyotrophic lateral sclerosis(ALS)-(United States)

Patient name: German Roman
Gender: Male
Age: 57 years old
Nationality: United States
Disease diagnosis: Amyotrophic lateral sclerosis (ALS)

Before treatment:
Three years ago, the patient began to show weakness in the left upper limb, which gradually spread to the limbs, with obvious weakness in the left upper limb, inability to lift the arm, difficulty in clenching fists, gradual atrophy of the muscles of the extremities and obvious weight loss. A year and a half ago, he developed weak speech, dysphagia and drinking water choking. He began to have difficulty breathing in the recumbent position 3 months ago, and he has worn a non-invasive ventilator.

Physical examination:
Blood pressure 154/93mmHg, pulse 67 beats / min, 18 breaths / min, blood oxygen 95%. Normal development and emaciation. No obvious abnormality was found in the systematic examination of general internal medicine.

Nervous system physical examination:
The patient's mind was clear, his speech was good, but his voice was low. His power of calculation and orientation was normal. His double pupils were 3mm in diameter, sensitive to light, flexible eye movements and no nystagmus. His forehead pattern was symmetrical, the tongue muscle was obviously atrophied, the tongue was extended in the middle, and the movement of the tongue muscle was weak. His bulging gills, chewing and lifting bilateral soft palate were weak. Turning neck and shrugging shoulders were weak. The muscle atrophy of his limbs was obvious, and the muscle bundles of his limbs could vibrate. His left upper limb muscle strength was grade 2, left hand grip strength was grade 3; his right upper limb muscle strength and right hand grip strength were grade 3; when the patient was lying, his left hand could be adducted and translated, and his right hand could be raised to the head; his lower limb muscle strength was grade 4, and the plantar flexion and dorsiflexion of both feet were basically normal. The muscle tone of his limbs was basically normal. His tendon reflex was weakened. The pathological signs were negative. Meningeal irritation sign was negative.

Treatment process:
The patient’s admitting diagnosis was amyotrophic lateral sclerosis. During hospitalization, patient was treated with CAST and neural stem cells plus mesenchymal stem cells to repair motor neuropathy, nutritive nerve, improve the internal environment, immunomodulation, rehabilitation training etc. as comprehensive treatments.

After treatment:
The patient's condition improved, his chewing and swallowing function was significantly improved, the movement speed of tongue muscle was accelerated, the speed of eating was increased, the meal eating could be finished in half an hour, the choking of drinking water was significantly reduced, the respiratory function was improved, and the voice of speech was increased. The motor function of his limbs improved, the muscle strength of both upper limbs increased by 30%, and the muscle strength of his left upper limb increased by 3%. When he was in the recumbent position, the raising height of his left upper limb increased by 30cm, the left hand could be lifted to the nose, and the grip strength of his left hand was 3 +; his right upper limb muscle strength was 4, and the grip strength of his right hand was 4. The muscle strength of his lower limbs was 4 +. His energy, physical fitness and sports endurance have all improved significantly.