Ali Saleh Al Yami-Multiple Sclerosis-(Saudi Arabia)
The second round of treatment:
Name: Ali Saleh Yami
Sex: Male
Nationality: Saudi Arabian
Age: 36Y
Diagnosis: Multiple Sclerosis
Discharge Date: 2019/09/08
Before treatment:
19 years ago there was no obvious cause for pain in the patient's right shoulder and right arm. 13 years ago he could not open his right eye powerfully, he had blurred vision, no diplopia and a gradual progression of pain, numbness and weakness in the right side limbs. When the temperature rose the patient felt powerless. He was diagnosed with multiple sclerosis nine years ago. Numbness of the left limbs occurred 7 years ago and was treated in Germany 4 years ago (the specific treatment is unknown). After treatment his condition did not improve significantly. Three years ago he came to our hospital for treatment and after that the strength of the right limbs was better than before. The strength of the right arm improved after discharge. A year ago he began to feel the right limbs, waist and back strength had declined. His balance function declined and had intermittent sense of acupuncture. He could take care of himself, could walk independently but the strength of the right limbs was weakened. The weakness of the right leg was obvious and he was limping when walking.
He has normal appetite, poor sleep, occasionally has urgent urination needs and intermittent use of defecation aids (polyethylene glycol 4000).
Admission PE:
Bp: 136/96mmHg, Hr: 68/min, breathing rate: 22/min, body temperature: 36.0 degrees. Nutrition status is good with normal physical development. There is no injury or bleeding spots of his skin and mucosa, no blausucht. Chest development was normal, chest movement range was decreased when he was breathing, the respiratory sounds in the lower lungs were weak, there was 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, shifting dullness was negative, spinal column was normal and there was no edema of the legs.
Nervous System Examination:
Patient was alert with normal mental status, his speech was slightly affected. His memory, comprehension and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3 mm, the reaction to light was sensitive, no nystagmus and the eyeballs can move freely. The bilateral forehead wrinkle and nasolabial fold are symmetrical, he can make his tongue extend out normally, the tongue muscle can move freely and showing teeth was normal. He could bulge his cheeks powerfully, chewing ability was normal, the soft palate can lift normally and the uvula turns to the left side. There was muscle atrophy of the bilateral shoulder girdles, 4 limbs, thenar muscles, hands interosseus muscles, the neck was soft, his shrug and turning neck ability was weak. The proximal side muscle power of the arms was 1 degree, right distal side muscle power was 2 degrees, the left side distal muscle power was 1 degree. His leg muscle power was 1 degree. The hands fingers joints were rigid, he could not grasp, can only move his fingers slightly, the 4 limbs muscle tone were lower, right elbow joint cannot bend well and the 4 limbs tendon reflex can not be induced. His bilateral Babinski sign and Hoffmann sign were negative, he only can perform the right hand finger opposite movement with one finger, left side cannot perform that movement at all. He could not perform the finger to nose test or fast alternate movement because of weakness. The heel-knee-tibia test cannot be performed, the meningeal irritation sign was negative.
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, improve body environment, regulate his immune system and improve blood circulation. This was combined with rehabilitation training.
Post-treatment:
After 14 days treatment his appetite improved, the muslce power of the right side of his body was increased 20%. He could now stand on the left leg for 15 seconds and for 5 seconds for right leg. He walked better and could go up stairs easier. The right forearm can now move slightly, right hand grip force improved, the left hand fingers can move with much more flexibility and his pain is alleviated.
The first round of treatment:
Diagnosis: Multiple Sclerosis
Date of Admission: August 15th, 2016
Before treatment:
Ali felt pain in right shoulder and upper limb with no motivation 16 years ago, it was hard for him to open his right eye 10 years ago. He didn’t have diplopia, his disease became worse and worse, he went to a local hospital and diagnosed with multiple sclerosis 6 years ago. His right limbs were numb 4 years, he went to Germany 1 year ago and received regular treatment, but he didn’t get better. At present, he feels acanthesthesia and numbness sometimes, he takes Gabapentin 400mg, 3 times a day, his right limbs are weakness, especially his right lower limb, he limps when he walk. He wants a better life so he comes to our hospital.
His spirit, diet and sleep were good. Sometimes he will had urgency of urination, he used Polyethylene Glycol 3350 each day to help defecation.
Admission PE:
Bp: 125/83mmHg, Hr: 79/min, body temperature: 36.3 degrees. Height: 175cms, weight: 93kgs. His physical condition was normal, his nutritional status was good. The skin and mucosa were normal, with no yellow stains or petechia. Oropharynx was not congestive. His bony thorax was symmetrical. The respiratory sounds in both lungs were normal, there was no dry or moist rales. The heart sounds were strong. The cardiac rhythm was regular, with no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. His liver and spleen were normal. Shifting dullness was negative. Spinal column was normal. There was no edema in both lower limbs, his anus and external genitalia were not examined.
Nervous System Examination:
Ali Saleh Al Yami was alert and his spirit was good, his speech was clear. His memory, orientation and calculation ability were normal. Both pupils were equal in size and round, the diameter was 3mm. Both pupils were insensitive to light stimulus. Both eye fields were normal. His right side vision was poor and blurred. He didn’t have nystagmus. The forehead wrinkles were symmetrical. Bilateral nasolabial sulcus was equal in depth. His mouth and teeth were in the right position without deflexion. His tongue was centered in his mouth, his tongue muscle was normal, uvula was in the right position. His neck more freely, the muscle tension of his four limbs was normal. The muscle power of left limbs was normal, the muscle power of right upper limb was at level 5-, the muscle power of right lower limb was at level 3-. The tendon reflex of right limbs was normal, the left limbs’ tendon reflex was weak. The abdominal reflexes were not elicited. His palm jaw reflex, bilateral Hoffmann and Babinski sign were negative. Bilateral ankle clonus was negative. The right side of the body was more sensitive than the left. His right finger to nose test was not well, right rapid rotation test was clumsy, his left finger to nose test and rapid rotation test were normal. Bilateral finger to finger test and ankle-knee-tibia test were normal. Bilateral heel-knee-tibia test were normal. He was able to stand on right leg for 3 seconds, he was able to stand on left leg for 5 seconds. His meningeal irritation sign was negative.
Treatment:
After the admission, he received related examinations and diagnosed with multiple sclerosis, he received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged nerves, replace dead nerves with new injected stem cells, active stem cells in his body, regulate immune system, nourish nerves and improve blood circulation. He also had rehabilitation training.
Post-treatment:
After 21days of treatment, his limbs’ numbness and pain reduced obviously, right upper limb’s rapid rotation test improved, his right limbs were more powerful, the muscle power of right upper limb was at level 5, right lower limbs was at level 4+. He was able to stand on one leg for longer time, left leg was basically normal, right leg for 7 seconds.
