Name: Luis Rafael Molina Diaz
Sex: Male
Nationality: Swedish
Age: 60Y
Diagnosis: 1. Amyotrophic Lateral Sclerosis (ALS) 2. Hypertension (3 degrees) 3. Diabetes (Type2)
Discharge Date: 2018/06/01

Before treatment:
The patient couldn’t raise his right arm powerfully in 2013, 6 months later he felt weak in his other three limbs and  he also had muscle atrophy. He went to a local hospital and was diagnosed with ALS. In 2016 he was unable to walk and had problems with breathing. In 2017 he began to use a respiration machine for breathing. He couldn’t move at all.
His spirit is normal, he has bad sleep and a bad diet. His urination and defecation functions are normal. He has hypertension and has had  diabetes for many years.

Admission PE:
Bp: 155/118mmHg, Hr: 87/min, breathing rate: 18/min, body temperature: 36.0 degrees. Nutrition status is normal with normal physical development. There are no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion and his tonsils do not have swelling. The respiratory sounds in both lungs were weak with no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was soft and bulging with percussive tympany and mild tenderness. The liver and spleen were normal, shifting dullness was negative, there was no edema in the legs.

Nervous System Examination:
Patient was alert and mental status was fine with clear speech. His orientation,  memory and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3 mm, react well to light and the eyeballs can move freely. There was no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical, he could make his  tongue extend out as normal and there was no tongue muscle atrophy. Showing the teeth was normal and the tongue can touch the cheek powerfully. Patient could bulge his cheeks  and chew powerfully. The bilateral soft palate could lift powerfully, he could close his eyes as normal. There was obvious muscle atrophy of his bilateral shoulder girdle, biceps muscle, triceps muscle, intercostal muscle, latissimus dorsi, quadriceps femoris, biceps femoris muscle and gastrocnemius muscles. His neck was soft, he could not turn his neck powerfully and the shrug ability was weak. The muscle power of the arms was 1 degree, the hands grip force was 0 and his his fingers could not bend. Muscle power of the legs was 0-1 degree, the 4 limbs muscle tone was low and the ankle clonus was negative. Bilateral biceps reflex and the radial periosteal reflex could not be induced, the patellar tendon reflex of the legs and Achilles tendon reflex could not be induced also. The bilateral palm-jaw reflex,  Hoffmann sign, Rossilimo sign and the Babinski sign also could not be induced by examination. He could not perform the finger to nose test, finger opposite movement or fast alternate movement because of weakness. The heel-knee-tibia test also could not be done. The meningeal irritation sign was negative.

Treatment:
After the admission he received related examinations and was given 3 times nerve regeneration treatment(neural stem cells and mesenchymal stem cells) and nerve protection treatments to repair his damaged nerves, activate stem cells, replace dead nerves, nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.     

Post-treatment:
After 14 days treatment his abdominal distension was better, hyperphagia, blood pressure and blood sugar levels were now controlled in a much more stable manner. The proximal side adductor muscle power of the arms reached  2 degrees, his breathing function improved, the lower lungs breathing sound was much clearer than before and the blood oxygen concentration was 96-99%. The muscle power of his legs reached 1 degree.