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Mr.Lee-Amyotrophic Lateral Sclerosis(Britain)

Author Zhangqi Views Posted at 2017/07/07

Name: Mr.Lee
Sex: Male
Nationality: British
Age: 67Y
Diagnosis: Amyotrophic Lateral Sclerosis (ALS)
Date of Admission: Feb. 11th, 2017
Treatment hospital/period: Wu Medical Center/15 days

Before treatment:
The patient had serious pneumonia 2 years ago. It was hard for him to cough and his voice was low and weak. He went to a local hospital and was diagnosed with Amyotrophic Lateral Sclerosis (ALS) and his condition became worse. It was hard for him to speak or swallow and his whole body was weak. He took Riluzole 50mg once a day but his condition wasn’t controlled. He began to have respiration problems and he lost a lot of weight. He began to wear an IV/BiPAP breathing machine in August 2016. He had gastrostomosis surgery in September 2016 then after that he wore a respiration machine all night. There was obvious muscle atrophy. For now, his four limbs are weak and he needs help with eating and dressing. He is able to sit up and stand by himself but slowly, he is able to walk 20-30 steps but his exercise tolerance is bad. He wants a better life so he came to our hospital.
His spirit, diet and sleep are all good. His bladder and bowel functions are normal. He has lost around 20 kgs.

Admission PE:
Bp: 143/99mmHg, Hr: 71/min, breathing rate: 19/min, body temperature: 36 degrees. Height 168cm, weight 50.8Kg. Nutrition status is normal and he has normal physical development. There is no injury or bleeding spots on his skin and mucosa, no blausucht, no throat congestion, and his tonsils do not have swelling. Chest develop is normal but the breathing sound of the lower lungs area is slightly weaker, there was no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and with no obvious murmur in the valves. The abdomen was soft, with no masses or tenderness.  The liver and spleen were normal, shifting dullness test is negative. The spinal column is normal, there was no edema in either leg. Sat is 90-95%.

Nervous System Examination:
Patient was alert and mental status was good but he cannot speak. The memory, orientation and calculation ability were normal . Both pupils were equal in size and round, diameter of 3mm, react well to light and the eyeballs can move freely. No nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, his tongue is in middle, with tongue muscle atrophy. The tongue cannot move freely especially in the vertical direction. Showing of the teeth is normal. Patient cannot bulge his cheeks powerfully, his chewing ability is poor and the soft palate cannot lift powerfully. Pharyngeal reflex is weak but the patient can close his eyes as normal. There is obvious muscle atrophy in the bilateral shoulders, arms and bilateral thenar muscles. The neck is soft and he can turn his head and shrug powerfully. Muscle power of the left arm:adduction abductor muscles of upper arm is 4- degrees; forearm flexor muscle power is 3 degrees, extensor muscle power is 3+ degrees, grip force of the left hand is 4- degrees. Muscle power of right arm: adduction abductor muscles of upper arm is 4- degrees; forearm flexor muscle power is 3 degrees, extensor muscle power is 3+ degrees, grip force of the left hand is 4 degrees. Muscle power of the legs is 4 degrees. All 4 limbs muscle tone is normal and the ankle clonus is negative. The bilateral bicipital tendon reflex, radial periosteal reflex, patellar tendon reflex and Achilles tendon reflex can not be induced by examination. The palm-jerk reflex of both sides are positive, the Hoffmann  sign of both sides are negative, bilateral Babinski sign is negative, finger to nose test and the fast alternate movement are clumsy The finger opposite movement of the left side is clumsy, right side is much better. Heel-knee-tibia test is basically normal. Meningeal irritation sign is negative.

Treatment:
After the admission he received related examinations and was diagnosed with ALS. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections to repair his damaged nerves, replace dead nerves with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 15 days treatment his breathing function is better, the oxyhemoglobin saturation increased to 95-97%, movement endurance increased, muscle strength of the four limbs is stronger than before, he can stand independently and his gait is better than before. Muscle power of the arms is better, his left upper arm can lift higher, the finger-finger test of the left hand is better, the right hand grip is now at level 5-. Both  his spirit and energy have improved. He is now able to walk longer, around 30-50 meters.

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