Fatima Al-Muhairi-Multiple sclerosis-(United Arab Emirates)

Patient Name: Fatima Al-Muhairi
Gender: Female
Age: 22 years
Nationality: United Arab Emirates
Diagnosis: Multiple sclerosis

Admission Condition:
The patient was admitted due to "recurrent episodes of double vision, back pain, and weakness in the limbs for over 8 months," diagnosed with "multiple sclerosis." She had previously received treatment with "methylprednisolone" and "interferon," and was currently still using "interferon." After each injection, she felt fatigued, and the treatment has not been effective.

Physical Examination on Admission:
The patient’s heart rate was 85 beats per minute, and blood pressure was 125/70 mmHg. She appeared well-developed, well-nourished, and of normal build. There was no jaundice or petechiae on the skin. Breath sounds in her both lungs were clear, and heart sounds were strong with no murmurs in the auscultation areas of the heart valves. Her abdomen was soft, with no enlargement of the liver or spleen.

Neurological Examination:
The patient was alert and spoke fluently. Her memory, calculation, and orientation were normal. The pupils on her both sides were 3.0 mm in diameter and react well to light; however, there was noticeable horizontal nystagmus in her both eyes. The movement of her both eyes towards the temporal side was inadequate, resulting in double vision, with a separation of 3 cm when the target was 30 cm away. The visual fields were significantly narrowed, with the temporal fields measuring approximately 70 degrees, and the nasal and inferior fields approximately 40 degrees. Her facial features were symmetrical, the tongue was midline, and there was no air leakage during cheek puffing; the elevation of the soft palate was normal. Her neck was supple with no rigidity. There was pain in her neck and back, rated at 8 out of 10 (on a scale of 0-10), which the patient reported affected her daily life and sleep. Muscle strength in her limbs was rated at 4 out of 5. In a supine position, she could only sustain the hip and knee flexion in her both legs for 5 seconds. Muscle tone was generally normal, and deep tendon reflexes were largely normal with no pathological signs. Her facial sensation was normal, but deep and superficial sensation, as well as fine touch in her limbs, were slightly diminished. The patient performed the finger-to-nose test, rapid alternating movements, and heel-to-shin test adequately. The eyes-closed balance test was negative, and her balance was acceptable, being able to stand on one foot, and she could perform the toe-heel standing task adequately. Signs of meningeal irritation were negative.

Treatment Process:
After admission, the patient was clearly diagnosed with "multiple sclerosis." She underwent inpatient treatment for 2 weeks, receiving mesenchymal stem cell therapy to modulate the immune system, and neural stem cell therapy to repair nerve axons and myelin damage, along with adjunctive CAST therapy and comprehensive rehabilitation treatment.

Post-Treatment:
The patient’s symptoms have significantly improved. The horizontal nystagmus has disappeared, and double vision is mostly resolved; her visual field has returned to nearly normal; her neck and back pain has markedly decreased, now rated at 2-3 out of 10; muscle strength in her limbs has improved to 5 out of 5, and she can sustain the hip and knee flexion in her both legs for 15 seconds with resistance. Deep and superficial sensations, as well as fine touch in the limbs, have nearly returned to normal.