Suhail Naser Saleh Alandas-Multiple Sclerosis-(Saudi Arabia)

Name: Suhail Naser Saleh Alandas
Sex: Male
Nationality: Saudi Arabian
Age: 31Y
Diagnosis: Multiple Sclerosis

Before treatment:
The patient felt lower limb numb and week 3 years ago, it was hard for him to walk, he also had balance problems, his language function was normal. He did MRI and was diagnosed with multiple sclerosis in 2014 year. He did steroid treatment but his blood pressure was higher after the treatment, so the steroid was changed to Tysabri 300 mg, once a month. In rencent 2 years, his lower limbs were weak and stiff, the right side was worse. At present, he uses walker to walk, it is easy for him to feel tired. His knee will be pain after long walking, sometimes he falls down. He is able to turn over, sit up and stand up.
His spirit is good, his diet is bad, he feels abdominal distension after eatting, his sleep is good. He puts up 14 kgs in 3 years. In recent two months, it is hard for him to control urination or defecation.

Admission PE:
Bp: 137/89mmHg, Hr: 70/min, body temperature: 36.7 degrees. height was 184cm, weight was 77kg. Nutrition status is normal, normal physical development. There was a scar around 3cm in his left forehead side, others nbody skin was dine, no yellow stain or bleeding spot. No congestion of throat, no tonsil swollen. Chest development was normal, the respiratory sounds in both lungs were clear, no moist rales. The heart beat is powerful with regular cardiac rhythm, with no obvious murmur in the valves. The abdomen was soft and plate, with no masses or tenderness. Liver and spleen were normal, shifting dullness was negative, spine column was normal, no edema of lower limbs.

Nervous System Examination:
Patient was alert and mental status was good, clear speech, his memory, orientation and calculation ability were normal. Both pupils were equal in size and round, diameter as 3.0 mm, react well to light, eyeballs can move freely, no nystagmus, his eyesight was normal by gross measure, no diplopia, no visual field loss.. Bilateral forehead wrinkle is symmetrical. The bilateral nasolabial groove depth is same, tongue is in middle position, no tongue muscle atrophy, show teeth is normal, the uvula was in middle position. Soft plate can lift as normal. neck can move freely, patient can shrug powerfully. Left upper limb muscle power amd  left hand grip force were 5 degree. the right upper limb muscle power was 4 degree, right hand grip force was 4- degree. the left lower limb muscle power was 4+ degree, right lower limb muscle power was 3+ degree. the upper limbs muscle tone was normal. the lower limbs muscle tone increased slightly. His right upper limb biceps reflex was active, radial periosteal reflex was normal, his left upper limb tendon reflex was normal. patient lower limbs patellar tendon reflex was hyperactive, abdominal reflex was normal. the bilateral palm-jaw reflex was negative, the Hoffmann sign of both sides was negative, bilateral Babinski sign was positive, the ankle clonus was negative. His sensory examination was normal. left side finger to nose test, finger opposite movement were stable and correct, left side fast alternate movement was normal, right side finger to nose test and finger opposite movement were not stable, right side fast alternate movement was clumsy, the lower limbs heel-knee-tibia test was not stable, the Romberg's sign was positive. He could not walk straightly. Patient could not stand with one leg, the meningeal irritation sign was negative.

Treatment:
After the admission, he received related examinations, he received 3 times nerve regeneration(neural stem cells and mesenchymal stem cells) treatment to active stem cells, repair his damaged nerves, replace dead nerves, nourish nerves, regulate his immune system and improve blood circulation, with rehabilitation training.     

Post-treatment:
After 12 days’ treatment, his movement ability improved 20%, he walked better, his gait got better, the step pace increased. The fast rotation test of his right side was better. He could stand with one leg and keep for 5 seconds,he could more easily to stand up from sitting position, the muscle power of both upper limbs was increased,especially his left upper limb increased 1 level.


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