Tenille Ellie-ALS-(South Africa)-Posted on October 19th, 2015

Name: Tenille Ellie
Sex: Female
Nationality: South Africa
Age: 34 Years
Diagnosis: Amyotrophic Lateral Sclerosis
Date of Admission: Sept. 9, 2015
Treatment hospital/period: Wu Medical Center/22 days

Before treatment:
The patient’s left ulnar finger had convulsive motions 5 years ago, but she didn’t care too much. 2 years later, the condition was not better, and she felt weakness of her hand, so she went to the local hospital and did the head and spine MRI, she also did the appendicular nerve conduction examination and diagnosed as Amyotrophic Lateral Sclerosis. The doctor recommended her to take Riluzole but she didn’t. she took some kind of supplements, did yoga and physical exercise. About 1 and half years ago, she got whole body muscular spasms, her chest and back were painful. 1 year ago, her four limbs were weakness, it was hard for her to walk, her step was slow and stiff. She also had whole body fasciculation, the proximal end of her lower limbs was worse. About 1 month ago, she speak unclear. She wants a better life, so she comes to our medical center.
Her spirit, sleep and diet are normal, her urination and defecation were normal, she lost 7 kg.

Admission PE:
Bp: 105/72mmHg; Hr: 86/min; Temperature: 36.7 degree, Br: 18/min. Tenille is skinny. Her skin mucosa had no yellow stain or blooding spot. The pharyngeal had no congestion. The tonsil had one degree of swollen. The thorax was symmetrical and had no malformation. The breathing movement of thorax was slowly. The respiration of both lungs was low, with no dry or moist rales. Her heart rhythm was regular, without obvious murmur in the valves. The abdomen was soft with no rebound tenderness or pressing pain. Her liver and spleen were normal. The legs had no swollen. The sternocleidomastoid, shoulder girdle muscle, the forearm muscles, interosseus muscles, and thenar muscles have conspicuously atrophied.

Nervous System Examination:
Tenille was alerted. Her speak was blurred and unclear. Her spirit was normal. She had a normal orientation, memory and calculation. The diameter of both pupils was 3.0mms, and both pupils were equal in size and round. The pupils moved in full range, reacted normally to light stimulus and there was no nystagmus. She had symmetrical forehead wrinkles and her nasolabial groove was equal in depth. She could her eyes with ease. Her tongue was in the middle of oral cavity. Her corners of mouth were symmetrical when she displayed her teeth. She had slightly air leaking when she blew her cheeks. She had a weak chewing ability. The bilateral soft palate was symmetrical when she raised it up. The pharyngeal reflex was normal. She had a normal support to her head. The muscle strength of turning head and shrugging shoulder was level 5-. Her walking gait was stiff and slow. The exercise endurance went down. The abductor muscle power was at level 3, the angle was 60 degree. The muscle strength of flexor and extensor of arms was level 3. The muscle strength of pronation and supination was level 3. The muscle strength of bending and extending wrists was level 3. The gripping power was level 4. The muscle strength of interosseous was level 3. The thumbs of both hands could fully open if she made a fist. The ring finger and little finger of left hand could open 80%. The index fingers and middle fingers of hand could open 50%. The four fingers of right hand could not open if she made a fist. The muscle strength of legs was level 4. The muscle tone of legs was higher than normal. The tendon reflex was active. The abdominal reflex was disappeared. The bilateral ankle clonus was positive. The bilateral Hoffmann sign, Rossilimo sign and Babinski sign were positive. The bilateral deep and shallow sensation was normal. The finger-to-finger test could be done by left hand but right hand was able to close thumb to index finger. The rapid rotation was performed in a slow way. The finger-to-nose test and the heel-knee-tibia test were performed in a slow but accurate way. The meningeal irritation sign was negative. 

Treatment:
Her diagnose of Amyotrophic lateral sclerosis was confirmed. She received 4 times of neural stem cell injection and 4 times of mesenchymal stem cell injection to activate the cells, repair the damaged nerves, nourishes neurons, improve circulation, protect his immunity. She had also non-invasive ventilator to improve her breathing ability. This was companied with the rehabilitation for speaking and swallowing ability.

Post-treatment:
After 3-week’s treatment, she could speak clear, the pain in chest and back was gone, she could chew better, her exercise endurance was better. The muscle strength of four limbs was better. The abductor muscle power was at level 4, the angle was 90 degree. The muscle strength of flexor and extensor of arms was level 5-. The muscle strength of pronation and supination was level5-. The muscle strength of bending and extending wrists was level 5-. The gripping power was level 5-. The muscle strength of interosseous was level 3+. The thumbs of both hands could fully open if she made a fist. The ring finger and little finger of left hand could open 90%. The index fingers and middle fingers of hand could open 60%. The five fingers of right hand could open if she made a fist. When she bend her arms in front of her body, his right hand could open 80%.  The muscle strength of legs was level 4+. The muscle tone of arms  was normal, and legs was lower than before. The bi-ceps reflex, tri-ceps reflex and radioperiosteal reflex were better than before. The right side Hoffmann sign and Rossilimo sign were negative.

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