Ms. khalifa-Multiple Sclerosis-(sudan)

Name: Ms. khalifa
Sex: Female
Nationality: Sudanese
Age: 46Y
Diagnosis: Multiple Sclerosis(MS)

Before treatment:
2 years ago, the patient was unable to see clear with right eye, she also felt dizzy, so she went to hospital and did CSF test and MRI, she was diagnosed with MS, the doctors prescribed some medicines and the patient got better after took the medicines. Some months later, the patient can not move right upper limb well, so she went to hospital again, her condition was better after took medicines, then she found left lower limb stiffness, after that, the patient had bad movements of limbs repeated, she had balance problems, and her condition got worse, the doctor prescribe hypodermic infection AVONEX once a week, her condition got better. At present, the patient could walk with someone’s help for a short time, she is unable to walk steady, her four limbs are stiffness, she is unable to take care of herself. Her family members want her to have a better life so she comes to our hospital.
Her spirit, appetite and sleep are normal. Her urination and defecation functions are normal.

Admission PE:
Bp: 102/74mmHg, Hr: 64/min, breathing rate: 17/mim, body temperature: 36.0 degrees. Nutrition status is good, she was fat, normal physical development. The chest development is normal, respiratory sounds in both lungs were clear, no dry or moist rales. The heart beat is powerful with regular cardiac rhythm, with no obvious murmur in the valves. The abdomen was soft and bulging, with no masses or tenderness, no mass can be touched.

Nervous System Examination:
Patient was alert and mental status was fine,clear speech while slightly slow. The orientation ability, memory and calculation ability are normal, comprehensive ability is slightly slow. Both pupils were equal in size and round, diameter as 3mm, react well to light, eyesight is normal, she had gross horizontal nystagmus, eyeballs can more freely, while theconvergence ability was poor. Bilateral foreheadwrinkle and nasolabial fold are symmetrical, show teeth is normal, she can tongue out as normal, no tongue muscle atrophy. The uvula is in middle and her neck can move freely. The muscle tone of upper limbs are basically normal. Her left arm muscle power is 4- degree, of right arm is 4, the left hand grip force is 4 degree, of right hand is 4- degree. Muscle power of right lower limb is 3 + degree, of left lower limb is 2 + degree. The abdominal reflex can not be induced by examination, tendon reflex of upper limbs is normal, of lower limbs is weak. Sucking reflex is negative; jaw reflex is negative; bilateral Palm-jerk reflex is negative; the Hoffmann sign of left side is positive; of right side is negative; the Babinski sign of both sides is negative. Her sensory examinations are normal. She can perform the fast alternate movement slowly with upper limbs, finger to nose test and finger opposite movement ability is less stable. She can not perform the coordinate movement with left legs, and the right leg can done the movement clumsy. Patient had difficulty to stand herself. She can not walk straightly or perform the Romberg's sign examinations. The meningeal irritation sign is negative.

After the admission, she was diagnosed with MS (multiple sclerosis). She received 3 times nerve regeneration treatment to nourish nerves and improve blood circulation, control the infection, improve the body immune system function, combined with rehabilitation training.

After 14 days’ treatment, her movement endurance enhanced, 4 limbs movement ability improve very much, her balance function is better, 4 limbs muscle strength improved 20-30%, and the upper limbs control ability was get better, she could raise arms and grasp objects easier, she could control her upper limbs better and drink water by herself. She could stand and walk by herself.


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