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Judy-Amyotrophic Lateral Sclerosis(American)

Author Zhangqi Views Posted at 2016/03/29

Name: Judy
Sex: Female
Nationality: American
Age: 59
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Sinus Bradycardia
Date of Admission: Feb.23, 2016
Treatment hospital/period: Wu Medical Center/13 days

Before treatment:
About two years ago, Judy started feeling an unexplained weakness in her legs. At this time, she did not seek medical treatment. The weakness in the legs continued to get worse and one year ago, she developed fascicular twitching in the upper legs and her feet began to droop. Her walking gait was wider than normal. Her balance was unstable. There were no problems with swallowing liquids. The breathing was normal. Judy had visited her neurologist several times and after receiving an MRI of the brain and spinal cord, lumbar puncture and several EMGs, she was diagnosed with Amyotrophic Lateral Sclerosis (ALS), four months ago. She was prescribed Riluzole but there were no improvements to her condition.

Admission PE:
Bp: 136/90mmHg; Hr: 64/min; Temperature: 36.5 degrees, Br: 18/min. Sat 95%. Height 164cm, weight 69kg. The nutrition was good. There were no yellow stains or blood spotting on the skin mucosa. There was no pharyngeal congestion. The tonsils were swollen. The thorax was symmetrical. The respiration of both lungs was low, with no dry or moist rales. The heart rhythm was regular, without obvious murmur in the valves. The abdomen was flat with no rebound tenderness or pressing pain. The liver and spleen were normal. There was no swelling in the legs. There was only muscle atrophy in the feet.

Nervous System Examination:
Judy was alert. Her speech was clear but her voice was lower than before. She was in good spirits. She had a normal orientation, memory and calculation ability. The diameter of both pupils was 3.0mms, and both pupils were equal in size and round. The pupils had a full range of movement and reacted normally to light stimulus. There was a small amount of nystagmus. The forehead wrinkles were symmetrical. The eyes could be closed strongly. The nasolabial groove was equal in depth. The tongue was in the middle of the oral cavity, with normal flexibility. There was no atrophy of the tongue muscle or ventricular fibrillation. The corners of the mouth were symmetrical when she displayed her teeth. There was no air leakage when she expanded the cheeks. The chewing ability was normal. The bilateral soft palate was symmetrical when raised. The pharyngeal reflex was normal and there was no choking when she drank. There was no swallowing difficulty and the eating duration was normal. The support of the head was normal. The muscle strength for turning the head and shrugging the shoulders was level 5. The muscle strength of the upper limbs was at level 5-, the gripping strength was at level 5. The muscle strength of the lower limbs was at level 4.She could raise her legs away from the bed for 4 seconds, and felt her left side body was not as powerful as the right side. Her walking gait was wide, and she had difficulty maintaining her balance. Her physical endurance was decreased. Both feet drooped. The dorsoflexion movement was normal. She needed to wear corrective shoes when walking. The muscle tension of the upper limbs was normal; the muscle tension of the lower limbs was a little higher. The tendon reflex was active. The abdominal reflex was non-existent. The left palm jaw reflex was positive; the right palm jaw reflex was negative. Rossolimo’s sign on both sides was positive.  Babinski’s sign on both sides was neutral. Romberg’s sign was positive. The bilateral deep and shallow sensation was normal. The bilateral finger-to-finger test, rapid rotation test and finger-to-nose test were normal. The bilateral heel-knee-tibia test was performed in a slow but accurate way. The meningeal irritation sign was negative.       

After admission, we initially completed the physical examinations for the patient.  Judy had Sinus Bradycardia. Based on her examinations she was diagnosed with 1. Amyotrophic Lateral Sclerosis(ALS) 2. Sinus Bradycardia. As a result she received 3 neural stem cell injections and 3  mesenchymal stem cell injections to improve her nerve nourishment, circulation, regenerate the nervous system, repair the damaged nerves and regulate the immune system. She also had physical rehabilitation training.

After 2 weeks of treatment, Judy could move better, her exercise tolerance was better, she could speak more strongly. She could raise her legs higher when she walked. The muscle strength of the left foot was improved when she did the dorsoflexion movement. There was light amplitude. The endurance of both legs increased. When she raised her legs away from the bed, she could hold this position for 10 seconds. She could stand on one leg for a longer period of time. She had less fasciculation. The Sat was 97-99%.

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