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Martin Henderson-Motor Neuron Disease-(England)-Posted on Sept.18th,2015

Author Zhangqi Views Posted at 2015/09/18

Name: Martin Henderson
Sex: Male
Nationality: England
Age: 60 Years
Diagnosis: 1. Motor Neuron Disease 2. Hyperlipidemia 3. Arrhythmias Complete Right Bundle Branch Block I level Heart Function
Date of Admission: Aug. 19, 2015
Treatment hospital/period: Wu Medical Center/16 days

Before treatment:
The patient had clonic spasm in small thenar of both hands without any reason, but the patient had no treatment for that. About 1 year ago, he had fasciculation in abdomen; both of his lower limbs were weak when he walked. It didn’t get better after a few days rest. Both of his hands’ became weak. The muscle of both lower limbs was tense. He had fasciculation in all part of body. In Jan. 2015, he had electromyography and diagnosed as motor neuron disease. He took Riluzole 50mg q12h but the effect was not good. The patient had foreign body sensation in his throat, but his swallowing function was normal 4 months ago. He was short of breath 3 months ago. He can walk with a stick now. He always feels pain in the head, shoulders and neck. He has whole body muscular spasms, fasciculation, and it affects his daily life. He easily gets tired after exercise. He wants a better life, so he came to our medical center. He is diagnosed with motor neuron disease.

He lost 12kg, his spirit and sleep were good, he urinates 3 times/night, his excrement is normal.

Admission PE:
Bp: 124/80mmHg; Hr: 88/min. Br: 18/min. Temperature: 36.4 degree. His body type and nutrition were normal. There were no yellow stains or petechia on skin and mucous. His pharyngeal was not congested. The tonsil was not enlarged. His thorax was symmetrical, and the breathing mobility was normal. The respiration of both lungs was clear, the base respiration was weak, and the doctor could only hear it when the patient made deep breath. There were no dry or moist rales. The rhythm of his heartbeat was abnormal. Hr: 88/min. There was no obvious murmur in the valves. The abdomen was soft with no pressing pain or rebound tenderness. The liver and spleen were normal. There was no edema on both lower limbs. The doctor could palpate the dorsal artery of his foot. His left lower limb was violaceous in color after long time drop or hot shower. His CK level was higher than normal. Cardiogram: arrhythmias complete right bundle branch block.

Nervous System Examination:
Martin Henderson was alert and his spirit was good. He had a hoarse voice. His memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3 mms, both eyes had sensitive response to light stimuli. Both eyeballs could move freely. He didn’t have nystagmus. The forehead wrinkle pattern was symmetrical. The ability to close his eyes was strong. Nasolabials were equal in depth, his cheek blowing was strong, and his chewing muscle was strong. The tongue was centered in the oral cavity; the tongue muscle was slight atrophied. Keeping tongue in touch with cheek was strong. His tongue muscle was normal. He didn’t have teeth deflection. Both soft palates could be lifted, and the strength was strong. He didn’t choke while drinking. He had no difficulty in swallowing. His neck was soft. The muscle strength to turn over and raise his head was normal, and he could shrug his shoulder. He had muscular atrophy in sternocleidomastoid, ectopectoralis, shoulder girdle, upper limbs, thenar and hypothenar eminences, metacarpophalangeal and both lower limbs. The proximal end of four limbs and abdomen muscle had fasciculation. The abductor muscle power, adductor muscle power, flexor muscle power and extend muscle power were all at level 5. The grip of both hands was at level 5-. The muscle power of both lower limbs was at level 5-. The four limbs’ muscle tension was normal. He had bad exercise tolerance and easily gets tired. Both side biceps brachii reflex and radial periosteal reflex were weak. Both side triceps brachii reflex, lower limbs’ patella tendon reflex and ankle reflex were abnormal. Both side upper abdomen reflex and left side middle abdomen reflex were abnormal. Both side pathological sign was negative. The rough depth determination of both sides were normal, he could finish the finger-nose test and rapid rotation test normal. Left side finger-to- finger test was slowly done. When he touched his middle finger and little finger with thumb, his muscle between the thumb and index finger and carpomaetacarpal joint of thumb were painful. Both legs’ heel-knee-tibia test was normal. The meningeal irritation sign was negative.
Accessory examination: EMG (2015.1.2): the remote end and proximal end muscle had fasciculation, neurogenic abnormal, this is the symptom of motor neuron disease. Lumbar MRI (2015.2.27): he had prolapse of lumbar intervertebral disc in L3-4 without nerve root compression. He had L5-S1 laminectomy; the position of pedicle screw was good.  

Treatment:
According to the medical history of the disease and previous examinations he was diagnosed with 1. Motor neuron disease  2. Hyperlipidemia, 3. Arrhythmias Complete Right Bundle Branch Block I level Heart Function. He received 3 times of neural stem cell injection and 3 times of mesenchymal stem cell injection to activate the cells, fixes the nerves, improves circulation, and nourishes neurons. We used non-invasive ventilator for breath. We also gave him daily physical rehabilitation.

Post-treatment:
After the treatment, his condition was better. His grip was better, he could do finger to finger test well. His upper limbs muscle became large. He had less pain in neck, shoulder and head. His respiratory function had improved. The respiratory sounds in both lungs were stronger. He had an infection during his treatment; he had diarrhea, and hyponatremia. His neural function was a little lower. He got better after the treatment and his neural function also became better. His CK level was better than before. His blood lipid was lower.

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