Mr.Alsharief-Multiple Sclerosis-(Saudi Arabia)

Name: Mr.Alsharief
Sex: Male
Nationality: Saudi Arabian
Age: 52Y
Diagnosis: Multiple Sclerosis(MS)
Discharge Date: 2018/06/18

Before treatment:
The patient had left eye problems 20 years ago. He also had severe headaches so he went to a local hospital and was diagnosed with MS. He did hormonotherapy for 7 days and his vision function was improved. After that his symptoms returned every 6 months with his eyes, legs, speaking ability and swallowing functions all involved. He took Teriflunomide for 3-4 years and his disease was controlled but his muscle power decreased slowly but he could still walk by himself. Now he is unable to sit up, stand up or walk and he needs help with his daily life.
His spirit and diet are normal. He can’t sleep well. He urinates every hour and his defecation function is normal.

Admission PE:
Bp: 110/68mmHg, Hr: 75/min, body temperature: 36.7 degrees. His physical development is normal and nutrition status is fine. There is no injury or bleeding spots of his skin and mucosa,  no congestion of his throat and no swelling off his tonsils. The chest development was symmetrical and breathing sounds of both lungs were clear with no obvious dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. His abdomen was soft and flat with no masses or tenderness. His liver and spleen are in the normal position, shifting dullness was negative. Vertebral column is normal and there is no edema of the legs.

Nervous System Examination:
Patient was alert and his mental condition is fine with clear speech. The memory, calculation and orientation abilities are normal by examination. Both pupils were equal in size and round, diameter of 3.0mm, react well to light, eyeballs can move freely and there is no nystagmus. His eyesight was normal by gross measure, no diplopia and no visual field loss. Bilateral forehead wrinkle and nasolabial groove are symmetrical, tongue extending is normal with no tongue muscle atrophy and showing the teeth is normal. Soft palate can lift powerfully, the uvula was in middle, his neck can move freely and he can shrug powerfully. His arm muscle power was 4 degrees, his left leg muscle power was 2 degrees, right leg muscle power was 1+ degree. The muscle tone of the arms was normal, the leg muscle tone was increased. His biceps reflex was normal, the radial periosteal reflex was normal, his lower limbs patellar tendon reflex was active, the abdomen reflex could not be induced by examination. The bilateral palm-jaw reflex was negative, the bilateral Hoffmann sign was negative, the Babinski sign of both sides were positive, the ankle clonus was negative. The legs sensory test was decreased, he could perform the finger to nose test and finger opposite movement in a stable manner. His fast alternate movement was normal, he could not perform the heel-knee-tibia test because of weakness and he could not stand alone. 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 and muscle cells, replace dead nerves with new injected stem cells, nourish nerves and cells, regulate his immune system and improve blood circulation. This was done  with rehabilitation training.     

Post-treatment:
After 15 days treatment his balance control ability got better and the 4 limbs muscle power was stronger. He could raise his arms easier and better and his hands did fine movement better. The muscle power of the legs  increased 20% and he could now stand for 20 seconds by himself. He could walk a little with help and his balance function was better.

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