Nasser Mohammed Ayad-Spinal Cord Injury-(Saudi Arabia)

Name: Nasser Mohammed Ayad   

Sex: Male

Country: Saudi Arabia

Age: 21

Admission Date: 2010-10-01

Diagnosis: Spinal cord injury

Nasser was presented with dyskinesia in both lower limbs as a result of a car accident in August, 2009. He was conscious during the accident and instantly realized he had limited movement in his lower limbs. There was a sensory disturbance below the T6 level. He was sent to the local hospital immediately. Nasser received a spinal column X-ray, spinal column CT, and a spinal column MRI examination. The results suggested a T10-T11 level spinal cord injury. He received an operation to repair the damage 4 days later, but the outcome of the operation was unsatisfactory. After 5 more months of surgery, no real improvements were seen. After being discharged from the local hospital, Nasser received care from a home nurse and rehabilitation training for 1 month. His condition still did not improve.

Nervous System Examination:
Nasser was alert and could speak fluently. His memory, calculation abilities and orientation were all normal. Both pupils were equal in size and round, the diameter was 3.0mm. Both eyeballs could move freely and the pupils reacted normally to light stimulus. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. Nasser could move his neck normally. The shrugging strength of the shoulders was strong. The muscle tone of the upper limbs was normal, and the muscle strength of the upper limbs was level 5. The muscle tone of the lower limbs was decreased; the muscle strength of the lower limbs was level 0. The tendon reflexes of the upper limbs were normal and the tendon reflexes of the lower limbs was not elicited. The bilateral abdominal reflexes were not elicited.

Above the T6 level, the pain sensation, touch sensation, temperature sensation and depth of sensation were normal. Below the T6 level, all sensation had disappeared. The bilateral Hoffmann's sign and Rossilimo's sign were negative. The bilateral palmomental reflex was negative, the bilateral Babinski's sign was negative, and the bilateral ankle clonus was negative. The coordinated movement examination of both upper limbs was normal, but the lower limbs had difficulty with the examination. There were no signs of meningeal irritation.

We initially gave Nasser a complete examination. Then we proceeded with the stem cell activation treatment including nutrition for the neurons, improvement of the blood circulation to increase the blood supply to the damaged neurons. We had his body's resistance strengthened. We also gave him daily physical rehabilitation training.

Nasser is in a good mental state. He remains on a catheter. The muscle tone of both lower limbs has increased; the patellar reflex has been elicited, but is weaker than normal. The bilateral cremasteric reflex has been elicited, but it is delayed. The plane of sensitivity has declined. There is reduced sensation between the bilateral T6-T9 levels. There is vibration sensation between the T8-T9 levels. The controlling ability of the bilateral hip joints has improved obviously. The flexion position of both lower limbs can be maintained for 3 seconds while Nasser is in rehabilitation training. Nasser can control his lower limbs on his own occasionally. There are contractions of the muscles in his lower hips.


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