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Herlina Torres-Amyotrophic Lateral Sclerosis(American)

Author Zhangqi Views Posted at 2016/09/29

Name: Herlina Torres
Sex: Female
Nationality: American
Age: 54
Diagnoses: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Affective Disorder (anxiety and depression)  3. Hysterectomy(postop.)
Date of Admission: July 28th, 2016
Treatment hospital/period: Wu Medical Center/14days

Before treatment:
Herlina felt pain in the fingers of the right hand and right arm beginning 9 years ago. After that, she felt weakness in the right lower limb, then both left limbs, she also suffered from fasciculation. She was diagnosed with Amyotrophic Lateral Sclerosis 6 years ago, she was unable to walk 1 year ago, 7 months ago, she was unable to stand, and her respiration function was decreased, so she used a non-invasive ventilator. At present, she is unable to stand, walk or turn her body over. She constantly feels muscle pain, she is able to move the right upper limb, but her left upper limb is unable to be raised from the bed. Her respiration is weak. She has difficulty chewing and sometimes she chokes. She has intermittent anxiety, depression and other affective disorders. She is able to sleep while using a breathing machine. She eats soft food. Her urination is normal. She had constipation and she needs medicines to induce bowel movements, once in 3-4 days.

Admission PE:
Bp: 105/72mmHg; Hr: 90/min; Temperature: 37.0 degrees, Br: 19/min. Herlina’s physical condition was good, but her nutritional state was bad. Her skin mucosa was normal with no yellow stains or bleeding spots. The color of her lips was normal. There was no pharyngeal congestion. The tonsils were not swollen. The thorax was symmetrical. The respiration of both lungs was weak, the base of the lungs were weak, and could only be heard when she did deep breathing, with no dry or moist rales. Her precordial region was not raised. Her heart rhythm was regular and powerful, without obvious murmur in the valves. The abdomen was flat and soft, with no rebound tenderness or pressing pain. Her liver and spleen were normal. The shifting dullness was negative. The physiological curvature of the spine was normal. There was pitting edema in her lower limbs. Some parts of the skin’s temperature were lower than normal. The arterial wave of the foot was weak. Her anus and external genitalia were not examined.

Nervous System Examination:
Herlina Torres was alert and in good spirits. Her speech was unclear and her voice was lower than before. 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 moved in a full range, and reacted normally to light stimulus and there was no nystagmus. The forehead wrinkle pattern was symmetrical. She could close her eyes strongly. Her nasolabial groove was equal in depth. Her tongue was in the middle of the oral cavity, and moved normally. The corners of the mouth were symmetrical when she displayed her teeth. She was able to place her tongue against her cheeks normally. She had mild air leaking when she expanded her cheeks. Her chewing ability was a little weaker. She was able to raise her soft palate powerfully. Her neck was soft. She was able to shrug her shoulders strongly. The muscle strength to turn the head was a little weaker. The muscle strength of the right upper limb was at level 2, she could raise her arm to her chest. The left upper limb was at level 4, the gripping strength of the left hand was at level 4, her right hand was not able to grasp, and some of the distal ends of the fingers could bend. The muscle strength of the lower limbs was at level 2-, she had muscular atrophy of the limbs. The muscle tension was lower than normal. She had fasciculation. The bi-ceps reflex, tri-ceps reflex and radioperiosteal reflex were normal. The patellar tendon reflex was weaker. The bilateral palm jaw reflex was negative. The bilateral Rossolimo sign was negative. The left side Hoffmann sign was positive and the right side was negative. The bilateral Babinski sign was neutral. She was able to complete the finger-to-nose test with the left hand normally. The rapid rotation test and finger-to-finger test were not very good. She was unable to do the finger-to-nose test, rapid rotation test or the finger-to-finger test with the right hand. The bilateral heel-knee-tibia test was unable to be done. The meningeal irritation sign was negative. 

Treatment:
Herlina was diagnosed with 1. Amyotrophic Lateral Sclerosis(ALS) 2. Affective Disorder(anxiety and depression). She received 3 neural stem cell injections and 3 mesenchymal stem cell injections to initiate nerve replacement and nerve repair, activate the stem cells in the body, nourish the nerves and improve circulation. She also had rehabilitation training.             

Post-treatment:
After 14 days of treatment, Herlina’s motor skills improved. She was able to speak clearer. The sounds in the base of the lungs were clearer. The respiration was improved. She was able to move her right arm to her neck. Her right hand was able to grasp objects better. Her left hand’s gripping strength was improved to around level 5. Her exercise stamina was improved and her energy was improved.

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