Kim Jegon-Multiple System Atrophy-(Korea)

Name: Kim Jegon
Sex: Male
Nationality: Korean
Age: 65Y
Diagnosis: 1. Multiple System Atrophy(MSA) 2. Benign focal amyotrophy
Discharge Date: 2018/10/14

Before treatment:
The patient couldn’t walk well 3 years ago, he had swallowing and language problems and was diagnosed with MSA by a local hospital 2 years ago. He used some oral medicines but his condition still got worse. For now, he is unable to speak clearly, his swallowing function is bad, he has frequent urination at night and he can’t control his defecation function well. His diet and sleep are normal.

Admission PE:
Bp: 150/90mmHg, Hr: 68/min, breathing rate: 19/min, body temperature: 36.4 degrees. His height is 162 cm, weight 80Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion, and his tonsils do not have swelling. The respiratory sounds in both lungs were clear and 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 bulging and soft with no masses or tenderness. The liver and spleen were normal and there was no edema of the legs

Nervous System Examination:
Patient was alert, had dysarthria with slurred speech. His memory,  comprehension and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3 mm and the reaction to light was sensitive. The eyeballs can move freely and there was  mild horizontal nystagmus. The bilateral forehead wrinkle and nasolabial fold are symmetrical, he could make his tongue extend out normally, there was no tongue muscle tremor and the tongue muscle could not move with flexibility. The soft palate could lift powerfully, the uvula tended to right side and he could turn his neck powerfully. The 4 limbs muscle power was 5- degrees, the 4 limbs muscle tone were normal. He could sit up or walk slowly with a mildly unstable gait when he walked, He walked slowly with wide a step space and he could turn around slowly. The bilateral biceps reflex, triceps reflex, radial periosteal reflex decreased, the patellar tendon reflex and Achilles tendon reflex could not be induced by examination. The bilateral Hoffmann sign and Rossilimo sign were negative, the palm-jaw reflex of both sides were negative, bilateral Babinski sign was positive. His sensory system examinations were normal. The right hand finger opposite movement was clumsy, the last three fingers could not stretch straight, left side finger opposite movement was done slowly, finger to nose test was not stable or accurate. The bilateral fast alternate movement was clumsy, the heel-knee-tibia test was not stable and the Romberg's sign was positive. He could stand with one leg for only 5-6 seconds and he could not walk straight. The meningeal irritation sign was negative.

Treatment:
After the admission he received 3 cell regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged brain nerves, replace dead nerves, nourish nerves (ganglioside and neurotrophic factors), regulate his immune system and improve blood circulation. This was combined with rehabilitation training.     

Post-treatment:
After 14 days treatment his language function and balance function were better than before, his pronunciation was clearer, the flexibility of finger to nose and rapid rotation test of both arms was improved. The stability of the body improved when standing with closed eyes, he stood on one leg for 8-10 seconds and he now urinates less at night.

 

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