By Dr. Pearly Liu
The patient is a 43-year-old male, he presented progressive motor disturbance of his four limbs for 20 years, and his symptoms have become more aggravated during the past 7 months. He was diagnosed with MS (multiple sclerosis).
Admission PE: Bp 100/88 mmHg, HR 96/min. Normal nutrition status. There is normal development of his chest. His heart, lungs and abdomen are all ok.
Neural system examination: alert, mental status is weak. The patient has rigid facial expression. He has speech disturbance. There are disturbances when his eyes look upward and his left eye looks to left side. He has diplopia of the left visual field; there is vertical nystagmus of both eyes. His tongue protrudes to the left side slightly, with mild tongue muscle atrophy of his left side. The soft plate cannot lift powerfully. Muscle tone of his 4 limbs is higher than normal with severe rigidity of his lower limbs. The muscle force of his right arm is 1 degree, while the left side and both legs are 0 degree. Abdomen reflex is normal. Tendon reflex of both lower limbs are active. Sucking reflex and palmomental reflex is positive. Pathology reflex of both lower limbs are positive. He has hypalgesia on the right side of the body, and he cannot coordinate his movements completely.
Diagnosis: MS (primary-progressive)
Treatment results: The patient’s mental status improved very much, he has natural facial expression, his movement of his eyeballs is much more flexible than before. He can speak more clearly and his swallowing ability has improved markedly. He can control his neck much better and the muscles in his four limbs are stronger than before. He can move his legs in bed smoothly. His left hand and wrist can lift over the bed and his left thumb and forefinger can move slightly. His right hand can move flatly in bed and the last three fingers of his right hand can move a little bit.
Case analysis: MS is a kind of autoimmune disease characterized by demyelisation of white matter of CNS. Most patients had neural function disorder repeatedly, the disease had remission and relapse many times, and the patient’s condition will deteriorate gradually. This patient was diagnosed with MS (primary-progressive), and this type of disease is difficult to get to respond to general therapy. After 2 cycles of treatment, the patient had obvious improvement. Yet during his stay in the hospital, the patient had a lung infection because of bucking and aspiration and he had a fever that greatly exhausted his energy. After the infection, the patient had deep vein thrombosis of his lower limbs, we had to limit the movement of his legs, and because of this, we could not give the patient scheduled rehabilitation training. It influenced the training plan of the functioning of his lower limbs, but we still achieved the expected goal on time. MS is acknowledged around the world as an untreatable disease, but we make every effort to block the development of the disease successfully, and the stem cells treatment is a new hope for many patients suffering from MS.