Meshari Altamimi-Multiple Sclerosis-(Saudi Arabia)

Name: Meshari Altamimi  
Sex: Male
Nationality: Saudi Arabian
Age: 39Y
Diagnosis: 1. Multiple Sclerosis 2. Bedsores

Before treatment:
The patient had a fever 6 years ago. After that he found it was hard for him to move his limbs so he went to hospital and had some treatments but his condition was not improved. He had fevers over and over, his motor functions got worse and worse and he was diagnosed with multiple sclerosis. He has had urination and defecation problems in recent years, his swallowing function is bad and he has abnormal emotion and spirit. He does know who his family members are, his legs are malformed, he has a bedsore on his foot and he is unable to take care of himself.
His spirit is weak, he eats little, only having 1000ml of paste food per day. He uses catheterization for urination, his sleeping is normal and he has mood swings.

Admission PE:
Bp: 114/77mmHg, Hr: 101/min, body temperature: 36.3 degrees. The patient has normal physical development but poor nutrition status. There were many bedsore ulcers in the bilateral dorsum of the foot and the heels. The skin color was dark and covered by purulent secretion, other skin in the body was normal. He has pharyngeal congestion, no tonsil swelling, breathing sounds of in both lungs were clear and there was no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and with no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. Liver and spleen were normal by touch, shifting dullness was negative. The physiological curvature of the spine was normal, there was mild edema of the ankle joints.

Nervous System Examination:
Patient was alert, mental status was weak and speech was not very clear. His response ability and comprehensive ability was not very good. He could not cooperate with the examination of calculation, memory or orientation ability. Both pupils were equal and round, diameter of 3 mm, react well to light, eyeballs can move freely but he could not complete the examination of facials. Neck can move freely, right arm muscle power was 4- degrees, grip force was 3 degrees, left arm muscle power was 4 degrees, grip force was 3 degrees, his leg muscle power was 1 degree. The  muscle tone of the arms was basically normal, his left leg extensor muscle tone was high but the legs had bending malformation. The  tendon reflex of the arms was active, but of the legs it was low, abdomen reflex was decreased, bilateral palm-jaw reflex was negative. The bilateral Hoffmann sign were a doubtful positive, the Babinski sign of both sides were positive. Bilateral ankle clonus were negative, he cannot complete the sensory examination. Patient cannot do the arm coordinator movement examination or the heel-knee-tibia test. The meningeal irritation sign was negative.

After the admission he received related examinations and received 3 times nerve regeneration treatment to repair his damaged nerves, replace dead nerves, nourish nerves, regulate his immune system and improve blood circulation. This was done  with rehabilitation training.     

After 17 days treatment his spirit is better, he knew his family members, his language ability is better and his voice is higher and clearer. He could take food much easier, the muscle power of his legs was increased 1 level and he was able to eat food by himself. The leg muscle tone was lower, the bedsore ulcer area had made good recovery and there was new fresh skin re-growth.

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