Luay - SCI ( Saudi Arabia) Updated on May 20th,2015
The fourth round treatment:
Name: Luay Anwar Abdul jawad
Sex: Male
Country: Saudi Arabia
Age: 26 years
Diagnosis: 1. sequel of spinal cord injury 2. sinus bradycardia
Date: Apr. 11th, 2015
Days Admitted to Hospital: 23 days
Before treatment:
The patient had an accident 4 years ago, he couldn’t move his four limbs, sensory deprivation, urinary and fecal incontinence. The local hospital found C5-6 injury after MRI, so he had neck operation, after that, his upper limbs had part function, he could raise a little, but couldn’t move his fingers. He went to our hospital on 2012 and 2013, after the treatment, he could control his upper limbs and lower limbs better. He could raise his upper limbs but he couldn’t grasp. He didn’t had depth feeling below T5, he couldn’t move his lower limbs. He had urination and defecation problems. His family wanted a better treatment so he came to our hospital.
His spirit was good, his diet and sleeping were good, he couldn’t control his urination and defecation, his weight was lighter.
Admission PE:
Bp: 113/47mmHg; Hr: 52/min. Br: 19/min. Well nutrition. The skin and mucosa with no yellow stains or petechia. The thorax was symmetrical. The respiratory sounds in both lungs were clear with no signs of dry or moist rales. The cardiac rhythm was regular. There was no murmur in the valves. The abdomen was soft with no tenderness or rebound tenderness. The liver and spleen were normal. There was an operation scar on the neck.
Nervous System Examination:
Luay was alert and he was in good spirits. The speech was clear. The memory, calculation abilities and orientation were normal. Both pupils were equal in size and their diameter was 2.5mms. 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. Both side soft palates could lift strongly. The pharyngeal reflex was normal. The flexor and extensor muscle power were at level 4. The adduction and abduction muscle power were at level 4-, the extensor muscle power of wrist was at level 3. His fingers could do light activity. The muscle power of thumb was at level 2-. His both lower limbs couldn’t do autonomic activities, the muscle power was at level 0. He couldn’t bend his knees. The muscle tension of both upper limbs was normal, both lower limbs was a little higher. The superficial sensibility of right C6,C7 was disappeared, C8 to T6 was decreased, under T6 was gone. The superficial sensibility of left C8 to T4 was decreased, under T4 was gone. The vibration sense below T6 of both side was gone. Both side abdominal reflexes was abnormal. The tendon reflex of four limbs was lower than normal. The bilateral Hoffmann’s sign and palm jaw reflex were negative. The both side Babinski’s sign and meningeal irritation sign were negative. Luay was unable to complete the finger-to-nose-test, the heel-knee-shin test or the rapid rotation test.
Treatment:
We initially gave Luay a complete examination and he was diagnosed with sequel of spinal cord injury. Then we proceeded with the nerve nutrition, and improved the blood circulation in order to increase the blood supply to the damaged neurons. This was combined with daily physical rehabilitation training.
Post-treatment:
The abducent muscle strength of right upper limb was better and the muscle strength reached level 4. The movement of both thumbs were more flexible. Other fingers of the hands had slight movement. He had better control of both upper limbs. The patient could control the posture of arms when he raised arms. The muscle power of both lower limbs was better than before, it was at level 1. He was able to finish slight adduction and abduction action when he bent hip and knees on the bed. The superficial sensibility and deep sensibility was better.
Name: Luay Anwar Abdul jawad
Sex: Male
Country: Saudi Arabia
Age: 23
Diagnoses: Spinal cord injury (SCI), urinary tract infection
Admission Date: March 1, 2012
Days Admitted to Hospital: 28
Before treatment:
Luay was involved in an accident in July, 2010. As a result, he lost voluntary muscle control in the arms and legs, as well as sensory loss and incontinence. At the local hospital the MRI examination showed damage to cervical vertebrae 5-6. Luay underwent neck surgery but the arms and legs still had akinesia. About 45 days after the accident, Luay went to a hospital in China and received further treatment. After the treatment, the arms had some movement and could be raised slightly, but the fingers still couldn't move. Luay participated in a physical rehabilitation program at his local hospital and then six months ago, decided to go to a hospital in Beijing for the second round of treatment. After this round of treatment was completed, Luay could feel the muscles in his chest and back get stronger. He was able to sit in a more stable manner but there was no other real progress in his condition. At the time Luay was admitted to our medical center, he was able to raise both arms but had difficulty grasping objects with his fingers. The deep and shallow sensation below the chest was diminished. Luay was unable to move his legs and as a result had difficulty caring for himself.
Nervous System Examination:
Luay was alert and was in good spirits. The speech was clear and distinct. The memory, calculation abilities and orientation were normal. Both pupils were equal in size and their diameter was 2.5mms. Both eyeballs could move freely and the pupils reacted normally to light stimulus. There was horizontal nystagmus in the right eye. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. The neck had flexible movement. The adduction muscle strength of the right upper limb was level 4, and the abduction muscle strength of the right upper limb was level 2-. The adduction muscle strength of the left upper limb was level 4-, and the abduction muscle strength of the left upper limb was level 2-. Both hands had difficulty with movement. Only the thumbs had slight movement. Both lower limbs had no voluntary movements and the muscle strength was level 0. The lower limbs had mild muscle spasms when there was passive activity. The muscle tone of both upper limbs was almost normal. The muscle tone of both lower limbs was slightly higher than normal. The tendon reflexes of both upper limbs were normal; the tendon reflexes of both lower limbs were weak. The bilateral abdominal reflexes were not elicited. The shallow sensation above the bilateral cervical vertebrae segment 6 was normal. Right side:The shallow sensation between the cervical vertebrae segment 6 and the cervical vertebrae segment 7 was diminished. The shallow sensation between the cervical vertebrae segment 8 and the thoracic vertebrae segment 5 was diminished. The shallow sensation below the thoracic vertebrae segment 5 was diminished. Left side:The shallow sensation between the cervical vertebrae segment 8 and the cervical vertebrae segment 3 was diminished. The shallow sensation below the thoracic vertebrae segment 3 was diminished. The vibration sensation above the bilateral thoracic vertebrae segment 6 was normal. The vibration sensation below the bilateral thoracic vertebrae segment 6 was diminished. The bilateral Hoffmann's sign was positive. The bilateral palm jaw reflex was negative. The sucking reflex was negative. The left side Babinski sign was positive. The right side Babinski sign was negative. Luay was unable to complete the finger-to-nose-test, the heel-knee-shin test or the rapid rotation test. The laboratory test of urine showed white blood cells were ncreased and full of visual field.
Treatment:
We initially gave Luay a complete examination and he was diagnosed with a spinal cord injury. Then we proceeded with the nerve nutrition, and improved the blood circulation in order to increase the blood supply to the damaged neurons. He also received treatment for autologous cells activation, nerve repair and nerve regeneration. This was combined with daily physical rehabilitation training.
Post-treatment:
The muscle strength of the upper limbs has increased slightly from before. The upper limbs can be elevated and rotated to the outside of the body further than before and the control over the movements of the upper limbs has improved. The adduction strength of the left upper limb is level 4. The abduction strength of both upper limbs is level 2+. The muscle strength of both lower limbs has increased and is now level 1. There were muscle contractions when the knees and hips were flexed. The plane of sensation is lower. Luay has sensation in bilateral cervical vertebrae segment 6, cervical vertebrae segment 7 and thoracic vertebrae 3, but the sensation is still weaker than normal. The sensation in left thoracic vertebrae 4 is not stable, sometimes appearing and other times disappearing. Luay was put on a long-term indwelling catheter. After admission to our medical center he came down with a urinary tract infection and was given anti-inflammatory treatment. After the treatment, the infection was alleviated. White blood cells in urine: 3-5/H.
Luay's parents email to us:
2012-05-02
"Dears,
I would like to pass my apperciation and this is second report follow up for lab test for my son Luay Anwar Abduljawad to be seen and update any information needed. the firest one has been sent befor.
For your information since I follow up with the doctor and rehab consulting Luay gain the following:
There are improving in sitting Position by 60%.
There are no & Loose dizziness of integrity in position.
Standing on the standing table & infringement of the clinical bed standing.
Hand improvement in stretch elbow.
I have one form for PT&OT follow-up to be fill down and get easy for patina to recorded or the evaluator.
Your action is apperciated.
Best Regards.. . . "
Anwar A. Abduljawad"
Second round treatment:
Admission Date: April 29, 2012
Days Admitted to Hospital: 47
Before treatment:
Nervous System Examination:
Luay was alert and he was in good spirits. The speech was clear and distinct. The memory, calculation abilities and orientation were normal. Both pupils were equal in size and their diameter was 2.5mms. Both eyeballs could move freely and the pupils reacted normally to light stimulus. There was horizontal nystagmus in the right eye. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. The neck had flexible movement. The adduction muscle strength of the right upper limb was level 4, and the abduction muscle strength of the right upper limb was level 2-. The adduction muscle strength of the left upper limb was level 4-, and the abduction muscle strength of the left upper limb was level 2-. Both hands had difficulty with movement. Only the thumbs had slight movement. Both lower limbs had no voluntary movements and the muscle strength was level 0. The lower limbs had mild muscle spasms when there was passive activity. The muscle tone of both upper limbs was almost normal. The muscle tone of both lower limbs was slightly higher than normal. The tendon reflexes of both upper limbs were normal; the tendon reflexes of both lower limbs were weak. The bilateral abdominal reflexes were not elicited. The shallow sensation above the bilateral cervical vertebrae segment 6 was normal. Right side: The shallow sensation between the cervical vertebrae segment 6 and the cervical vertebrae segment 7 has disappeared. The shallow sensation between the cervical vertebrae segment 8 and the thoracic vertebrae segment 5 was diminished. The shallow sensation below the thoracic vertebrae segment 5 has disappeared. Left side: The shallow sensation between the cervical vertebrae segment 8 and the cervical vertebrae segment 3 was diminished. The shallow sensation below the thoracic vertebrae segment 3 has disappeared. The vibration sensation above the bilateral thoracic vertebrae segment 6 was normal. The vibration sensation below the bilateral thoracic vertebrae segment 6 has disappeared. The bilateral Hoffmann��s sign was positive. The bilateral palm jaw reflex was negative. The sucking reflex was negative. The left side Babinski sign was positive, the right side Babinski sign was negative. The meningeal irritation sign was negative. Luay was unable to complete the finger-to-nose-test, the heel-knee-shin test or the rapid rotation test.
Treatment:
We initially gave Luay a complete examination and he was diagnosed with a spinal cord injury. Then we proceeded with the nerve nutrition, and improved the blood circulation in order to increase the blood supply to the damaged neurons. This was combined with daily physical rehabilitation training.
Post-treatment:
The flexibility of the fingers has increased more than before. The movement range of the right fingers has enlarged. The right hand can grip a cell phone. The muscle strength of right lower limb has increased slightly and reached level 1. When the patient's lower limbs are in the flexion position, he can maintain the flexion position and can do adduction and abduction actively. There are obvious adduction actions when both lower limbs are hanging.
The third round treatment:
Admission Date: April 4, 2013
Days Admitted to Hospital: 28
Before treatment:
The patient received rehabilitation 8 months ago. After rehabilitation, the patient had better control of both upper limbs' posture. Before the treatment, the patient could raise upper limbs. But he still couldn't finish the grasp action. The deep sensation and shallow sensation below the chest had disappeared. Both lower limbs had absolutely no movement. He had poor control of both lower limbs' posture. He had bowel and bladder dysfunction. He lost the ability to care for himself.
Nervous System Examination:
Luay was alert and was in good spirits. The speech was clear and distinct. The memory, calculation abilities and orientation were normal. Both pupils were equal in size and their diameter was 2.5mms. Both eyeballs could move freely and the pupils reacted normally to light stimulus. There was horizontal nystagmus in the right eye. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. The neck had flexible movement. The adduction muscle strength of the right upper limb was level 4, and the abduction muscle strength of the right upper limb was level 2-. The adduction muscle strength of the left upper limb was level 4-, and the abduction muscle strength of the left upper limb was level 2-. Both hands had difficulty with movement. Only the thumbs had slight movement. Both lower limbs had no voluntary movements and the muscle strength was level 0. The lower limbs had mild muscle spasms when there was passive activity. In supine position, if the doctor bends both the patient's knees passively, the patient can't keep the position by himself. The muscle tone of both upper limbs was almost normal. The muscle tone of both lower limbs was slightly higher than normal. The tendon reflexes of both upper limbs were normal; the tendon reflexes of both lower limbs were weak. The bilateral abdominal reflexes were not elicited. The shallow sensation above the bilateral cervical vertebrae segment 6 was normal. Right side: The shallow sensation between the cervical vertebrae segment 6 and the cervical vertebrae segment 7 was not present. The shallow sensation between the cervical vertebrae segment 8 and the thoracic vertebrae segment 5 was diminished. The shallow sensation below the thoracic vertebrae segment 5 was not present. Left side: The shallow sensation between the cervical vertebrae segment 8 and the cervical vertebrae segment 3 was diminished. The shallow sensation below the thoracic vertebrae segment 3 was not present. The vibration sensation above the bilateral thoracic vertebrae segment 6 was normal. The vibration sensation below the bilateral thoracic vertebrae segment 6 was not present. The bilateral Hoffmann's sign was positive. The bilateral palm jaw reflex was negative. The sucking reflex was negative. The left side Babinski sign was positive, the right side Babinski sign was negative. The meningeal irritation sign was negative. Luay was unable to complete the finger-to-nose-test, the heel-knee-shin test or the rapid rotation test.
Treatment:
We initially gave Luay a complete examination and he was diagnosed with a spinal cord injury. Then we proceeded with the nerve nutrition, and improved the blood circulation in order to increase the blood supply to the damaged neurons. Please see appendix for detailed treatment procedure. This was combined with daily physical rehabilitation training. The patient was suffering from a toothache on the right side upon admission. A dental specialist gave the patient a consultation. There was an abscess in the first molar root and fascial space infection. The patient received apocenosis and decompression drainage treatment. The patient also received an antibiotic for anti-infective therapy. After treatment, periodontal redness and swelling has disappeared. The toothache has disappeared. It is recommended that the patient have root canal therapy upon returning home.
Post-treatment:
The abducent muscle strength of right upper limb is better and the muscle strength reached level 3-. The patient can resist slight resistance. The movement of both thumbs is more flexible. Other fingers of the hands have slight movement occasionally. He has better control of both upper limbs. The patient can control the posture of his arms when he raises them. The muscle strength of both lower limbs is better than before. He is able to finish slight adduction and abduction action of both lower limbs. The tendon reflex of both lower limbs is better than before and the tendon reflex is elicited, but the tendon reflex is still weaker than normal. The superficial sensibility in right cervical vertebra 6-7 has disappeared. The superficial sensation flat in the trunk has enlarged and moved down. The superficial sensation from cervical vertebra 8 to thoracic vertebra 6 has slowed down. The superficial sensation below thoracic vertebra 6 has disappeared. The superficial sensation from cervical vertebra 8 to thoracic vertebra 4 of left side has slowed down. The superficial sensation below thoracic vertebra 4 has disappeared. The vibration sense above bilateral thoracic vertebra 6 is normal. The vibration sense below thoracic vertebra has disappeared. The vibration sense of the right big toe has improved. The vibration can be perceived by the right big toe. Left side Babinski sign is positive. Right side Babinski sign is negative.
