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Mike-Multiple System Atrophy-(Canada)

Author Zhangqi Views Posted at 2019/01/10

Name: Mike
Sex: Male
Nationality: Canadian
Age: 63Y
Diagnosis: Multiple System Atrophy (MSA)
Discharge Date: 2018/08/06

Before treatment:
The patient fell down a lot 3 years ago and it was hard for him to get up from the ground. After that he had urination problems, postural hypotension, ataxia, felt down a lot, his gait was abnormal and he walked slowly. He also spoke slowly and unclearly. He went to a local hospital and was diagnosed with MSA in December 2015. His disease progressed slowly, both hands showed  intention tremor, he couldn’t walk well or hold objects, he moved slowly, it was hard for him to turn his body over and he fell down a lot. He used disposable catheters for urination 4-6 times per day.
His diet and sleep are normal, he defecates 1-2 times per day.

Admission PE:
Bp in lying position: 150/91mmHg, Bp in standing position: 100/85mmHg, Hr: 68/min, breathing rate: 18/min, body temperature: 36.2 degrees. His height is 178 cm, weight 78Kg. Nutrition status was good with normal physical development. There was 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 clear and there was no dry or moist rales. The heart beat was powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was flat and soft, with no masses or tenderness. The liver and spleen were normal and there was no edema of the legs.

Nervous System Examination:
Patient was alert, had dysarthria with slurred and slow speech. His memory was decreased, the comprehension and calculation abilities were normal. Both pupils were equal in size and round, diameter of 2.5 mm and the reaction to light was sensitive. The eyeballs can move freely with no nystagmus. The bilateral forehead wrinkle and nasolabial fold were symmetrical, he could make his tongue extend out normally, there was no tongue muscle tremor but the tongue muscle could not move with much flexibility. The soft palate could lift powerfully, the uvula cannot be seen. He could turn his neck powerfully, there was arm tremor, mainly intention tremor. The arm muscle power was 5- degrees, leg muscle power was 4 degrees and the 4 limbs muscle tone were normal. The bilateral biceps reflex, triceps reflex, radial periosteal reflex and patellar tendon reflex could not be induced; Achilles tendon reflex was normal, bilateral Hoffmann sign and Rossilimo sign were negative, the palm-jaw reflex were positive, the Babinski sign of left side was positive, of right side was neutral and his sensory system examination were normal. His finger opposite movement was slow, had poor movement ability to perform fast alternate movement or finger to nose test, especially on his left side. The heel-knee-tibia test was not stable, the Romberg sign was positive and the meningeal irritation sign was negative.

Treatment:
After the admission he received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged nerves, replace dead nerves, nourish nerves (ganglioside and neurotrophic factors), regulate his immune system and improve blood circulation. This was combined with rehabilitation training.     

Post-treatment:
After 14 days treatment his blood pressure change from a lying posture to standing position reduced, his headaches were better and he spoke clearer. There was less tremor in his arms, his hands were flexible, his balance control improved, muscle power of his legs increased and he could now walk with a much more stable gait and for longer.

 

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