Robert Edward White-Amyotrophic Lateral Sclerosis-(Canada)
Name: Robert Edward White
Sex: Male
Nationality:Canadian
Age: 72Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis(ALS) 2. Cervical Spondylosis
Discharge Date: 2018/02/17
Before treatment:
The patient had twitching in his thumb 3 years ago and he also had muscle atrophy in both hands. His arms became weak as time went by so he had an MRI on his head and neck and the neck MRI showed cervical spondylosis. He was diagnosed with ALS 2 years ago. In the past 6 months his condition became worse, he had shortness of breath and he was unable to lie down when he slept.
His spirit is bad, he has bad sleep and diet. His urination and defecation functions are normal. He has cervical spondylosis, his head, neck and shoulders are painful.
Admission PE:
Bp: 135/75mmHg, Hr: 70/min, breathing rate: 26/min, body temperature: 36 degrees, blood oxygen concentration was 93%, height 181cm, weight: 85Kg, The patient had normal physical development. The breathing sounds of his lungs were clear with no rales. The heart beat was powerful with regular cardiac rhythm and no murmur in the valve areas. The abdomen was bulging with no masses or tenderness. His liver and spleen were normal with no edema of he legs.
Nervous System Examination:
Patient was alert, mental status was fine, he had clear speech, an anxious expression and the memory, calculation and orientation abilities are normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light, have mild horizontal nystagmus, his eyes could not converge and he has headaches and fainting. The bilateral forehead wrinkle and nasolabial groove are symmetrical, he could make his tongue extend out and showing teeth was normal. He wore the cervical gear and his neck could not move freely, his shrug ability was weak, there was obvious muscle atrophy of the bilateral shoulder girdle and arm muscle groups, especially in the proximal side. The check movement decreased, there was intercostal muscle atrophy. The 4 limbs muscle tone was normal. The right arm abductor muscle power was 3- degrees, adductor muscle power was 2- degrees and his right hand grip force was 1 degree. Left arm abductor muscle power was 3 degrees, adductor muscle power was 2+ degrees, left hand grip force was 2- degrees. The leg muscle power was 4+ degrees with lateral muscle spasm. The tendon reflex and bilateral abdominal reflex of the 4 limbs could not be induced. The arms, shoulders and back had pain and numbness, there was tuning fork vibration sense decreased in his feet, other sensory examinations were basically normal. Bilateral Hoffmann sign and Rossilimo sign were negative, palm-jaw reflex of both sides were negative, bilateral Babinski sign was and the ankle clonus were negative. The arms could not perform the coordinate movement because of weakness and muscle atrophy. The legs coordinate movement was normal. The meningeal irritation sign was negative.
Treatment:
After the admission he received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) 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 14 days treatment his sleep quality improved, mental status was much more stable, his respiration function was better and the blood oxygen concentration improved to 95-98%. His shoulder pain, neck pain and headaches alleviated. The muscle power of the arms increased 20%. He could now walk longer, better and there was less fasciculation in his legs.
