Mr. Binsaab-Multiple Sclerosis-(Saudi Arabia)

Name: Mr. Binsaab
Sex: Male
Nationality: Saudi Arabian
Age: 23
Diagnosis: Multiple Sclerosis
Date of Admission: August 17th, 2016
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
Mr. Binsaab felt dizzy in October 2015 with no reasons, he was unable to walk well, his upper limbs were weakness, it was easy for him to feel tired, he also had diplopia. He went to a hospital in America, he did brain MRI, blood test and CSF test, the result showed he had demyelination damage in brain, he was diagnosed with multiple sclerosis. The doctor prescribed methylpredmisolone, his condition went well, but several months later, he had above symptoms again, he also had obvious ataxia and dysarthria, he went to a local hospital and diagnosed with relapsing-remitting multiple sclerosis, the doctor prescribed methylpredmisolone again, he took it until he felt better. He began to take natalizumab 8 months ago, he felt better in 2 months. But in March 2016, his disease recurred again, his lower limbs were numb, he had ataxia and unable to walk, he took methylpredmisolone, but his disease got worse, on July 6th, 2016, his speaking was bad, he slavered, he was unable to walk, sit in balance, he also had urinary incontinence, he took corticotrophin medicines, he became better, but he still had ataxia. He was able to stand with someone’s help. At present, the patient has discontinuity dizzy, he doesn’t have diplopia, sometimes, he choked when he eat, it is hard for him to stand up, he is able to stand by himself for 1 minutes. He is able to walk for couple steps with walker, he is able to turn over and sit up. He needs someone help him with daily life, because his balance is bad. He wanted a better life, so he came to our hospital.
His spirit was good, his diet and sleep were normal. his weight showed no change. He had incontinence of urine, especial during night, his excrement was normal.

Admission PE:
Bp: 105/68mmHg, Hr: 67/min, body temperature: 35.9 degrees. Height: 165cms, weight: 57kgs. 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:
Patient was alert and his spirit was good, dysarthria. His memory, orientation and calculation ability were normal. Both pupils were equal in size and round, the diameter was 3mm. Both pupils react well to light stimulus. His eyesight is normal, no diplopia, both eye fields were normal. 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 middle position, soft plate can lift as normal. His neck can move freely, he can shrug as normal. The muscle power of upper limbs was at level 5, of lower limbs is 4 degree. Tendon reflex is normal, and abdomen reflex is normal, bilateral palm jaw reflex are negative, Hoffmann sign of both sides are negative, Babinski sign is positive, bilateral ankle clonus was negative.
Sensation examination:
Superficial sensitivity: touch and pain sensation decrease below the bilateral anterior superior spine.
Deep sensitivity: hypopallesthisia below the bilateral anterior superior spine. Skin topesthesia is normal.
Complex sensory examination: skin shape sensation disappear in both legs.
His finger to nose test and fingers opposite movement are less stable and accurate, the fast alternate movement test is slightly clumsy, the heel-knee-tibia test of both sides are not as stable as normal. His body tends to lean forward when he stand up, he can stand independently for 10s, while he can not stand with one leg. His Romberg sign is positive and meningeal irritation sign was negative.

Treatment:
He was 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 stem cells, active stem cells in his body, regulate his immune system, nourish nerves and improve blood circulation. He also had rehabilitation training.            

Post-treatment:
After 14 days of treatment, his balance function was better than before, his upper limbs’ fast alternate movement, fingers opposite test and finger to nose test are much stable than before, his walking posture with walker was better obviously, his speed of walking was faster, step pitch was better, the distance between the two feet was shorten than before, he can stand by himself for 90s. the deep sensation and superficial sensation was improved 30%.