Name: Jeffrey Beebe 

Sex: Male

Country: USA

Age:59 years

Diagnosis: Amyotrophic lateral sclerosis

Date:July 25, 2014

Days Admitted to Hospital: 19 days

Before treatment:

The patient suffered from weakness of right hand and slight swallowing difficulty without obvious inducement 1 year ago. He went to a local hospital and received 6 months treatment. He was diagnosed with Amyotrophic lateral sclerosis 6 months ago. He didn't received treatment at that time. The weakness of right hand aggravated gradually. The right upper limb, right lower limb and left upper limb were damaged too. The swallowing difficulty aggravated too. He suffered from slow speech and enunciation was unclear occasionally.

From the onset of disease, the patient's emotion was stable. The diet and sleep were normal. The defecation and urination were regular. His weight reduced by 40 pound. There was no genetic disease.

Admission PE:

Bp: 116/83mmHg; Hr: 86/min, temperature 36 deg. Br: 16/min. The patient was thin. His skin and mucosa were normal. The respiratory sounds in both lungs were clear, with no obvious rales. The heart sound was strong and the rhythm of his heartbeat was normal, with no obvious murmur in the valves. His abdomen was soft, with no pressing pain or rebound tenderness in the abdomen. The liver or spleen under the ribs were not enlarged. There was no swelling in both lower limbs.

Nervous System Examination:

Jeffrey Beebe was alert and his spirit was good. His speech was slow. His enunciation was not clear sometimes. 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. He was able to close his eyes with ease. The bilateral nasolabial sulcus was equal in depth. The tongue was at the center of his oral cavity. The teeth was shown without deflection. There was no obvious atrophy in tongue. The movement of tongue was flexible to each side. He had strong muscle to raise his soft palate. The uvula was in the center of oral cavity. There was air leakage when he drummed his cheeks. His neck was soft. He had strong muscle strength to turn his head and shrug his shoulders. The muscle strength of left upper limb to outreach was at level 4-. The muscle strength to bend and stretch his left upper limb was at level 5. The hold power of left hand was at level 4. The muscle strength of right upper limb to outreach was at level 3. The muscle strength to bend and stretch his right upper limb was at level 3. The hold power of right hand was at level 3 too. The muscle strength of left lower limb was at level 4. The muscle strength of right lower limb was at level 3. The muscle tone of his four limbs was almost normal. The ankle reflex of his right side was not elicited. Other tendon reflex of his four limbs was elicited normally. There was moderate muscle atrophy in bilateral (hand) fingers muscle, thenar muscles, both upper limbs' muscle group, bilateral supraspinatus and infraspinatus. The abdominal reflexes was not elicited. Bilateral palm jaw reflex was negative. The sucking reflex was positive. The jaw reflex was positive. Left side Hoffmann sign and Rossilimo sign were negative. Right side Hoffmann and Rossilimo sign were positive. Bilateral Babinski sign was negative. The deep sensation and shallow sensation, using loose measures, were normal. He was able to finish the finger-to-nose test in a stable manner. He was able to finish the rapid rotation test quickly. His left side did finger coordinate movement in a stable manner. Right side did finger coordinate movement in a clumsy manner. Right thumb couldn't point to little finger. He did the heel-knee-shin test in a stable manner. There were no signs of meningeal irritation.

Treatment:

We initially gave Jeffrey Beebe a complete examination. The patient received treatment for nerve regeneration and to activate stem cells in vivo. He received treatment to improve his blood circulation in order to increase the blood supply to the damaged neurons and to nourish them. He also received treatment for nerve regeneration and protect organ function. At the same time, he received Non-invasive ventilator for breath. This was accompanied by daily physical rehabilitation training.

Post treatment:

The patient's condition has improved. The muscle strength for cheek-bulging is stronger than before. He has better swallow ability. The pronunciation is clearer than before. The muscle strength of left upper limb to outreach is at level 4. The muscle strength to bend and stretch his left upper limb is at level 5. The hold power of left hand is at level 5. The muscle strength of right upper limb to outreach is at level 3+. The muscle strength to bend and stretch his right upper limb is at level 5-. The hold power of right hand is at level 5-. The muscle strength of left lower limb is at level 5. The muscle strength of right lower limb was at level 5-.