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Lassaad Bouaziz-Multiple Sclerosis-(Tunisia)-Posted on Jan.20th,2015

Views Posted at 2015/01/20

Name: Lassaad Bouaziz
Sex: Male
Country: Tunisia
Age:47 years
Diagnosis: Multiple Sclerosis
Date: December 19, 2014
Days Admitted to Hospital: 21 days

Before treatment:
Nine years ago (2005), the patient appeared paralyzed. The parts affected were both lower limbs without inducement. There were no any abnormality in the local hospital examination, they suspected Gillian Berry. After using gamma-globulin for treatment, patient achieved remission. 7 years before the onset of the disease, patient appeared to have weakness of both lower limbs. He has to walk with walking stick with the symptoms of spasm and urine incontinence. He has been to many hospitals then. They suspected multiple sclerosis. With the condition aggravated, patient gradually lost the ability to walk. He could not stand independently and he has balance disturbance with the symptoms of urinary incontinence, constipation and sexual function declined. He has been to many hospitals for the treatment,

Admission PE: 
Bp: 106/82mmHg; Hr: 75/min. His nutrition status is moderate. The thorax was symmetrical, the respiratory sounds of both lungs were clear, no rales. The heart sounds were strong, the rhythm was regular, and there was no obvious murmur in the valve area. The abdomen was flat and soft, with no obvious masses. There were no swelling of liver and spleen, both lower limbs skin temperature were low.

Nervous System Examination: 
Lassaad Bouaziz was alert and his speech was clear. His memory, calculation abilities and orientation were all normal. Both pupils were equal in size, the diameter was 3mms. Both eyeballs could move flexibly and the pupils reacted normally to light stimulus. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity and the teeth were shown without deflection. The neck moved normally. Both upper limb muscular tension and muscle strength was normal. Both lower limb muscular tension enhanced. He has paroxysmal spasm, the proximal muscle strength was 2+, distal muscle strength was 1+. Abdominal reflex was not found. Both upper tendon reflex was basically normal, both lower limb tendon reflex was active. Bilateral palm-jaw reflex and Babinski signs were negative. Bilateral Hoffmann sign was mild positive. The bilateral ankle clonus was positive. Patient could complete the fast alternating movement test and finger opposite test and finger-to-nose test. He could not do the heel-knee-tibia test. He could not stand by himself but with the help of walker. Meningeal irritation sign was negative.

Treatment:
We gave the patient treatment that will nourish the neurons, improve the blood circulation, improve the immune system function and it was combined with rehabilitation training, etc.

Post-treatment: 
After the treatment, patient’s muscle tension, tendon reflex and ankle clonus have reduced obviously than before. Myoclonus has been relieved. Both lower limb proximal muscle strength is 3-, distal muscle strength is 2. Both lower limb endings skin temperature back to the normal, basically. Urinating function improved than before, sitting balance improved slightly.

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