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Pedro Luis Arango Vega-Amyotrophic Lateral Sclerosis(Cuba)

Author Zhangqi Views Posted at 2016/07/07

Name: Pedro Luis Arango Vega
Sex: Male
Nationality: Cuban
Age: 54
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Hypertension I 3.Hyperlipemia
Date of Admission: April. 7, 2016
Treatment hospital/period: Wu Medical Center/15 days

Before treatment:
Pedro has had a progressive speech impediment, dyspnea and swallowing problems for four years, with the symptoms getting worse in the last two months. He also had weakness in the lower limbs. In April 2012, he spoke slower than normal, and also had emotional problems and difficulty with motivation. He would often cry or laugh spontaneously. The symptoms got worse and he was not able to speak clearly two years ago. Pedro had difficulty breathing at night and was not able to swallow very well. He was diagnosed with amyotrophic lateral sclerosis (ALS) at his local hospital and was prescribed Riluzole to control his condition but the medication was largely ineffective. There were spasms in the lower limbs and fasciculation in all four limbs eight months ago. Pedro always felt dryness in his mouth and he coughed a lot six months ago. The lower limbs became weaker two months ago. He is not able to speak clearly now, and has swallowing problems. He needs 70% more time than before when he eats, and chokes a lot when he drinks. He is not able to walk by himself. He also has forced laughing and forced crying.

Pedro eats a lot food. He doesn’t get sufficient amounts of sleep and he only sleeps 4-5 hours each day. Since two weeks ago, he has had an increased urge to urinate and is not able to control his urination. The bowel movements are normal.

Admission PE:
Bp: 136/74mmHg; Hr: 73/min. Br: 20/min. Temperature: 36.3 degrees. Body temperature: 36.3 degrees. There were no yellow stains or petechia on the skin or mucous membrane. There was no pharyngeal congestion. The tonsils were not enlarged. The thorax was symmetrical and the type was normal. When he breathed, the expansion of the lungs was weak. Fingertip oxygen saturation: 92-94%. The respiratory sounds in both lungs were clear, with no dry or moist rales. The rhythm of the heartbeat was normal. There was no obvious murmur in the valves. The abdomen was soft and bulged with no pressing pain or rebound tenderness. The liver and spleen were normal. There was no edema in the lower limbs. The blood lipid level was higher than normal.

Nervous System Examination:
Pedro Luis Arango Vega was alert and he was in good spirits. He was not able to speak clearly. His memory, calculation abilities and orientation were normal. Both pupils were equal in size and round, the diameter was 3 mms. Both eyes had sensitive responses to light stimuli. Both eyeballs could move freely. The nasolabial fold and forehead wrinkle pattern were symmetrical. His ability to close his eyes was powerful. His tongue was centered in the oral cavity and the tongue muscle was not atrophied. He was not able to move his tongue well. There was no deflection of the teeth. He was not able to expand his cheeks. He chewed powerfully and both soft palates could be raised, but the strength was weak. The pharyngeal reflex was weak. He had difficulty swallowing. He would choke when he drank water. The neck muscles were strong. The muscle power when shrugging the shoulders and turning the head were both at level 5. The gripping strength of both hands was at level 5.  The muscle power of both upper limbs was at level 5, the muscle tension was normal. The muscle power of the lower limbs was at level 3 and the muscle tension was a little higher than normal. The bilateral biceps reflex, triceps reflex and patella tendon reflex were over active. The radial periosteal reflex, achilles reflex, patella tendon reflex and abdominal reflexes were abnormal. The left side Rossolimo’s sign was positive. The bilateral Babinski’s sign was positive. The bilateral deep sensation and superficial sensation were normal. Pedro was able to complete the finger-to-finger test on both sides, but the rapid rotation test and the finger-to-nose test were done in an uncoordinated manner. He was not able to do the heel-knee-tibia test on the left side. The right side was done in an uncoordinated manner. The meningeal irritation sign was negative.

Treatment:
Pedro was diagnosed with Amyotrophic Lateral Sclerosis. He was given three neural stem cell injections and three mesenchymal stem cell injections to increase the number of normal cells in his body, and to repair the damaged nerves, regenerate the nerves, nourish the neurons, improve blood circulation, and improve the functioning of the immune system. A non-invasive ventilator was used to assist with breathing. We also gave him daily physical rehabilitation.

Post-treatment:
After two weeks of treatment, Pedro could speak clearly. He was able to chew powerfully. His swallowing ability was better than before, so he spent less time eating. He was able to breathe better and his SAT increased from 94% to 96%. The muscle power of the lower limbs increased to level 4. When Pedro walked, he was able to control his steps and walk farther. He was able to control his urination better.

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