Lusia Zenrry - MND (Indonesia) Posted on April 2, 2014

Name: Lusia Zenrry               
Sex: Male
Country: Indonesia
Age: 49
Diagnoses: Motor neuron disease, Amyotrophic Lateral Sclerosis
Days Admitted to Hospital: 23 days

Before treatment:
The patient suffered from weakness of his right upper limb in October 2011. The disease aggravated gradually. He went to a local hospital and received EMG and cervical nuclear magnetism. He was diagnosed with cervical spondylosis which exerted pressure on the nerve. The patient received rehabilitation, but his condition did not improve. The weakness of his right upper limb aggravated. He went to a hospital in Malaysia. He received hormone therapy for the treatment of myositis. About 6 months therapy, the disease still aggravated, he suffered from fasciculation and weakness of both lower limbs. This influenced his daily life. He was diagnosed with Motor neuron disease in December in Modern Cancer Hospital Guangzhou, China. He received stem cells regeneration, but the effect was not good. From the onset of disease, the patient had normal spirit. His diet and sleep was regular. He had normal defecation. His weight had no obvious change. There was no family (genetic) disease. His father had diabetes.

At present, the patient couldn't take care of himself. For further therapy, the patient came to our hospital.

Admission PE:
Bp: 140/92mmHg; Hr:85/min, temperature 36.4 deg. His development and nutrition was normal. The body type was normal. The skin and mucosa in the whole body was normal, with no yellow stains. There was no enlargement in the lymph node. The respiration of both lungs was normal, with no dry or moist rales. The heart rate was regular, with no obvious murmur. The abdomen was enlarged and soft, with no pressing pain or rebound tenderness. The liver and spleen were impalpable under the ribs. There was mild pitting edema in both dorsum of feet.

Nervous System Examination:
Lusia Zenrry was alert and his spirits was slightly weak. The examination of the memory, calculation abilities and orientation were normal. Both pupils were equal in size and round. Both eyeballs had normal movement and the pupils had normal reactions to light stimuli. The forehead wrinkle pattern was symmetrical. The eye closing ability was strong. The bilateral nasolabial sulcus was equal in depth. The tongue was at the center of the oral cavity. The tongue was shown at the center and with no obvious muscle atrophy. The tongue could move freely. The teeth were shown without deflection. The cheeks could be expanded, with no air leakage. Both side could raise soft palates with strong muscle. The muscle strength of left upper biceps brachii was at level 0. The muscle strength of left upper limb's near-end was at level 2 and the far-end was at level 3-. The grasp power of his left hand was at level 3+. The muscle strength of his right upper limb's biceps brachii was at level 0-1. The muscle strength of his right upper limb was at level 3-. The grasp power of his right hand was at level 3-. The muscle strength of both lower limbs' near-end was at level 2 and the far-end was at level 1+. There was atrophy in big and small thenar and lumbrical of both hands. There was severe muscle atrophy in bilateral forearm, upper arm muscle groups, around the shoulder blade and both lower limbs muscle groups. This was accompanied with large fasciculation. The muscle tone of both limbs was normal. The tendon reflex of four limbs was not elicited. Bilateral achilles tendon reflex was normal. Bilateral abdominal reflexes was weak. Bilateral jaw reflex, palm jaw reflex were negative. The bilateral Hoffmann's sign, Rossilimo sign and Babinski’s sign were negative. There was normal deep sensation and shallow sensation through the coarse scale. He was unable to finish the finger-to-nose test or the Heel-knee-shin test for the weakness of muscle strength. Both hands could finish the rapid rotation test and digital opposition test in a clumsy manner. There were no signs of meningeal irritation.

Treatment:
Lusia Zenrry received treatment to improve the blood circulation in order to increase the blood supply to the damaged nerves, nerve regeneration, and activate their own stem cells and to nourish the neurons. He was put on non-invasive mechanical ventilation to breathe. This was combined with daily physical rehabilitation training.

Post-treatment
Lusia Zenrry's muscle strength of his four limbs has improved. The muscle strength of his left upper limb's biceps brachii is at level 2-. The far-end of left upper limb has reached level 3. The muscle strength of his right upper limb’s biceps brachii is at level 1. The muscle strength of his right upper limb's and other part is at level 3. The grasp power of both hands has improved too. The muscle strength of both lower limbs' near-end is at level 2+ and the far-end is at level 2-. The fasciculation in his abdomen has reduced obviously. The abdominal reflexes is more sensitive than before. The muscle volume of both upper limbs' biceps brachii, scapular region and both lower limb's quadriceps femoris has increased than before. The endurance in the rehabilitation has improved obviously.