Fahad Mohammed Ibraheem Qattan-Multiple Sclerosis-(Saudi Arabia)

Name: Fahad Mohammed Ibraheem Qattan
Sex: Male
Nationality: Saudi Arabian
Age: 43Y
Diagnosis: 1. Multiple Sclerosis 2. Sleep Apnea Syndrome 
Discharge Date: 2019/06/20

Before treatment:
The patient developed sensory disturbance, numbness and no dyskinesia in the right limb in 2002 and 2005. It was considered as multiple sclerosis in the local hospital and the symptoms were completely relieved after 3 days. In 2012, there was no obvious inducement for right eye strabismus,  nausea and vomiting and other symptoms which were relieved after 7 days of hormone intravenous pulse therapy. In 2015, there was no inducement for movement disorder of the right limb, obvious limited leg lifting, limping of the right leg when walking, slight decrease of strength of the right hand and trembling during fine exercise. Hormone therapy was carried out but the symptoms were not relieved. In the following two years stem cell therapy was performed many times. After treatment the fine movement of the right arm was improved but the motor disorder of the right leg was not significantly improved. At present the patient's right leg muscle strength and balance ability is poor, he walks with crutches to maintain balance but he can basically take care of himself. The right hand occasionally wobbles.
His sleep, spirit and appetite are normal, urination and defecation functions are normal.

Admission PE:
Bp: 125/76mmHg, Hr: 65/min, breathing rate 18/min, body temperature: 36.6 degrees, height, 181cm, weight, 143kg. Patient has good nutrition status and normal physical development. He has an overweight figure, symmetrical chest, no dry or moist rales heard in both lungs, strong heart sounds, regular heart rhythm and no obvious murmur was heard. He has a bulging soft abdomen and dissatisfactory abdominal palpation.

Nervous System Examination:
Patient was alert, had good spirit, clear speech, normal memory, orientation and calculation abilities with normal intelligence. Both pupils were equal in size with a diameter of 1.0 mm and reacting sensitively to light. He had normal vision, free eyeball movement, nystagmus was observed when abducting, symmetrical forehead wrinkles and nasolabial folds. There was no deviation of the mouth corners when showing teeth, his tongue was in the middle when sticking out and there was no tongue muscle atrophy. The uvula was in the middle, there was no congestion of the pharynx, no swelling of tonsils, normal pharyngeal reflex and flexible neck movement. There was basically normal muscle tone of both arms and the left leg, increased muscle tone of the right leg.  There was grade 5 muscle power of both arms, grade 5  gripping power bilaterally, grade 5 muscle power of the left leg, grade 3 muscle power of the right leg. There was no dorsal flexion of the right foot, no abdominal reflex, normal bicep reflex bilaterally, normal radioperiosteal reflex, normal heel tendon reflex and knee tendon reflex on the left side, active heel tendon reflex and knee tendon reflex on the right side. There was negative sucking reflex, negative Hoffmann sign bilaterally, positive palm-jaw reflex and Babinski sign bilaterally. There was  basically normal deep and shallow sensation across the body, relatively stable and accurate fast alternate, finger to finger, and finger to nose movement and clumsy coordination movement of right leg due to muscle power problems. A positive Romberg's sign, negative meningeal irritation sign, difficulty walking in straight line and no ability to stand on his single right foot.

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 muscle tone of the right leg reduced, muscle power of right leg increased to grade 4 (20%), dorsal flexion appeared in the right foot with more and more power. His balance function was improved and he could now walk longer and better.

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