Yoo Sohyun-Amyotrophic lateral sclerosis (ALS)-(South Korea)

Patient Name: Yoo Sohyun
Gender: Female
Age: 24 years old
Nationality: South Korea
Diagnosis: Amyotrophic lateral sclerosis (ALS)

Condition upon Admission:
The patient was admitted primarily due to “progressive limb weakness and muscle fasciculations for 4 years, worsening with muscle atrophy for the past 2 years,” diagnosed as “Amyotrophic Lateral Sclerosis.” Currently, she was taking "Riluzole, Isobutylphenylacetate, Dextromethorphan and Quinidine mixture, and Guaiacol glyceryl ether," among others.

Physical Examination upon Admission:
The patient's heart rate was 71 beats/min, respiratory rate was 20 breaths/min, blood pressure was 95/66 mmHg, and blood oxygen saturation was 97%. She is normally developed and well-nourished. Cardiac, pulmonary, and abdominal examinations showed no abnormalities.

Neurological Examination:
The patient was alert but had difficulty speaking and unclear articulation. She had difficulty protruding her tongue, with evident tongue muscle atrophy. She experienced swallowing difficulties, unable to eat solid food, and occasionally choke while drinking. Her chewing ability was diminished. She had weak bilateral soft palate elevation. Her neck was flaccid, with weak head and neck control, often leaning backward. Maintaining a neutral head position was challenging. She exhibited grade 2+ muscular strength in neck and shoulder muscles. A strong emotional facial expression was often observed. She had grade 3 strength in the proximal muscles of both upper limbs; left wrist flexor and extensor strength were grade 2+, with grip strength at grade 2- and interphalangeal muscle strength at grade 2-; right wrist flexor and extensor strength were also grade 2+, with grip strength at grade 2- and interphalangeal muscle strength at grade 2-. She could not hold objects with her hands and had minimal grip strength. She had grade 3 muscular strength in both lower limbs, with left foot plantarflexor and dorsiflexor strength at grade 2- and right foot plantarflexor and dorsiflexor strength at grade 2-. She could not stand independently, had severe foot drop, and required significant assistance to walk. There was noticeable muscle fasciculation in her limbs, with occasional muscle pain. Bilateral knee reflexes were active, and bilateral pathological signs were present. Deep and superficial sensations were normal. Meningeal signs were negative.

Treatment Process:
The patient was clearly diagnosed with "Amyotrophic Lateral Sclerosis" and during her hospitalization, she received treatments including nerve stem cell therapy for motor neuron repair, mesenchymal stem cells to enhance nerve nutrition, endocrine and immune support, along with immunoglobulins, Edaravone, neurotrophic factors, and reduced glutathione for pathological improvement to support nerve repair. Comprehensive rehabilitation aimed at inducing nerve stem cell function was also implemented.

Post-Treatment Outcome:
The patient shows significant improvement in motor function, with an increase in overall strength. Neck and shoulder muscle strength improves to grade 4-. She can raise her head more quickly and steadily than before, with increased head-turning flexibility. She can maintain a neutral head position for over 20 seconds, and the frequency of her head tilting backward has noticeably decreased; her emotional facial expression has also lessened significantly. Proximal muscle strength in both upper limbs improves to grade 4+, with biceps and triceps able to resist considerable resistance. Grip strength in both hands is now grade 3+, and interphalangeal muscle strength is grade 3-, allowing her to grasp another person's fingers and resist some resistance. Muscle strength in both lower limbs improves to grade 4+, with both adduction and abduction able to resist significant resistance. Dorsiflexor and plantarflexor strength in both feet is at grade 3. She can stand independently for 20 seconds and walk with mild assistance. Her energy, physical capacity, and exercise endurance have all improved compared to before.