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Garie Lemont Price-ALS-(America)-Posted on Jan.12th,2015

Author Tracy Views Posted at 2015/01/12

Name: Garie Lemont Price                 
Sex: Male
Country: America
Age: 36 years
Diagnosis: Amyotrophic Lateral Sclerosis (ALS),Hyperthyroidism
Date: Dec. 8, 2014
Days Admitted to Hospital: 21 days

Before treatment:
      The patient is young, the onset of his disease progressed gradually. His both lower limbs were symmetrically mildly weakness 3 years ago and more and more serious , involved his both upper limbs. MRI showed his cervical spinal stenosis, so he received laminoplasty. After that, the patient noticed both upper limbs, especially right shoulder and both hands were more weak, he began to slurred speech, and that progressed gradually.  He began to dribble and was difficult to swallow with both hands and biceps brachii were atrophied, four limbs’ muscles twitched. Nerve specialist of local hospital diagnosed as: Amyotrophic Lateral Sclerosis, treated him with oral drugs, but the results was not  obvious, his illness turned more serious, he couldn’t look after himself, his spirit was not good, and it was difficult for him to chew and eat himself,  he depended gastrostomy tube to eat. He could sleep well, his urine was normal, he had constipation, defecated once a week. He went to our hospital to have better treatment. His cervical cord injured 19 years ago, and temporary paralysis of the body from the neck down, 2 months later, he was fully recovered. He received gatsrostomy 6 months before went to our hospital. No history of family hereditary disease.

Admission PE:
      Bp: 106/79mmHg; Hr: 85/min. BT: 36.1 degree, RP:19/min, there was 2cm*3cm decubitus on his right hip, it was not deep, surface of the wound was new, the skin around it was black. The rate of respiration of both lungs was weak, lungs’ sounds were quieter than normal, no obvious lung rales, thorax distensibility: 0.5cm, heart rhythm was normal, no obvious murmurs, abdomen was flat and soft, no pressing pain or rebound tenderness, the liver and spleen were normal, both lower limbs were not swollen.

Nervous System Examination:
      Garie Lemont Price was alert and inarticulate speech, low voice and unclearly.  His memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3.0mms, both eyeballs could move freely and the pupils reacted normally to light stimulus. The forehead wrinkle pattern was symmetrical. He had strength to close his eyes, Both nasolabials were equal in depth, cheed blowing strength was weak, muscles of tongue were depauperated. The movement of tongue was inflexible, and the teeth were normal and shown without deflection. Both soft palates could lift, but the strength was weak, he was hard to swallowed, he dribbled at the mouth. The muscle of neck was soft, the muscle strength of Looked up and turned around were both at level 4, the muscle strength to shrug his shoulder was at level 3, muscles all over his body were depauperated. The abducent muscles of both upper limbs were at level 1, the adductor, extensor and flexor muscle were at level 2, the grasp power of hand was at level 4. His both hands were flexion contracture,and his hands couldn’t extend especially the right one. The muscle strength of both lower limbs was at level 3, all of his body had fascicular twitching, the tension of four limbs muscle was mildly higher and clonospasm, Both upper limbs’ tendon reflex was active, both lower limbs’ tendon reflex were over active. Both sides l Hoffmann sign, Rossilim and Babinski sign were positive, both sides ankle reflex were positive. The deep and shallow sensation was normal through loose measure,he couldn’t finish finger-nose tes or legs’ heel-knee-tibia test. The meningeal irritation sign was negative.

      We diagnosed Garie Lemont Price: Amyotrophic Lateral Sclerosis, based on TSH was lower that normal and TSH was higher than normal, we asked his history of disease, he was afraid of hot and hyperhidrosis, he was diagnosed as Hyperthyroidism, he received consummate examination and he received treatment for repairing and regenerating nerves, activating his stem cells, improving circulation, nerve nutrition, repairing nerve. He breathed with the help of continuous postive airway pressure, and his hyperthyroidism was controlled, we also gave him daily physical rehabilitation.

      After the treatment, his condition gradually improved, astriction was batter, he defecates 3 times a day, the decubitus on his right hip is reduced to 1cm*1.5cm, it is not deep, surface of the wound is new, the skin around it is normal. The lungs’ sounds are clear and stronger than before, saliva dribbles less, the muscle strength to shrug his shoulder is at level 3+, the strength of abducent muscles of both upper limbs are at level 2, the strength of adductor and extensor muscle of left upper limb are at level 4-,flexor muscle is at level 2. The strength of extensor muscle of right upper limb is at level 4,flexor muscle is at level 3. The grip strength of both hands are at level 4, both muscle strength of lower limbs are at level 4, fascicular twitching is better, clonic spasm is less, and can recovered by himself. His treatment is over, he can leave hospital.



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