Rabbi Yitzchak Vider-Amyotrophic Lateral Sclerosis-(Israel)
Name: Rabbi Yitzchak Vider
Sex: Male
Nationality: Israeli
Age: 66Y
Diagnosis: Amyotrophic Lateral Sclerosis(ALS)
Discharge Date: 2017/09/26
Before treatment:
The patient felt weak in his right hand 6 years ago and his condition became worse and worse. He also had amyotrophy. 3 years ago he began to have language and swallowing problems so he went to a local hospital and was diagnosed with ALS. At present he can’t move his arms, his legs are weak, he can walk with others’ help, he speaks unclearly, has swallowing problems and has a weak respiration function.
His spirit, sleep, urination and defecation functions are normal.
Admission PE:
Bp: 155/97mmHg, Hr: 67/min, breathing rate: 20/min, body temperature: 36.2 degrees, blood oxygen saturation 89-92%. The patient has normal physical development and the nutrition status was good. There was no injury or bleeding spots of his skin and mucosa, no congestion of the throat, and no tonsil swelling. Chest development was normal, the chest movement decreased when he was breathing and he mainly depends on abdominal respiration. The breathing sounds of the left lung were clear and the right lung lower side was lower than normal with no rales. The heart beat was powerful with regular cardiac rhythm and no murmur in the valve areas. The abdomen was bulging with no masses or tenderness. His liver and spleen were normal, there was pitting edema of the legs below the ankle on both sides.
Nervous System Examination:
Patient was alert, his mental status was weak and he had slurred speech. The memory, calculation and orientation abilities are normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light with no nystagmus. The bilateral forehead wrinkle and nasolabial groove are symmetrical and he can close his eyes normally. He could not bulge the cheeks, he could make his tongue extend out toward the left side slightly, there was tongue muscle fibrillation and tongue muscle atrophy. The tongue muscles could not move freely, his tongue could not push against the isthmus or palate powerfully. His left arm could not move post stroke, muscle power of his left arm was 1 degree, left hand grip force was 1 degree. Right arm muscle power was 2+ degrees, right hand grip force was 2+ degrees. Left leg muscle power was 3+ degrees, right side was 4- degrees. There was middle muscle atrophy of both shoulder girdle muscles, biceps brachii, triceps muscle, hand and finger interosseus muscles. His 4 limbs muscle tone was decreased, tendon reflex of his arms was reduced and of the legs was normal. The bilateral ankle clonus was negative, the abdomen reflex could not be induced by examination. Bilateral palm-jaw reflex was positive, sucking reflex was negative, the Hoffmann sign of both sides was negative, the bilateral Rossilimo sign was negative, the Babinski sign of both sides could be positive. His sensory system exam was normal by gross measure. Patient could not perform the finger to nose test, fast alternate movement or finger opposite movement. The heel-knee-tibia test was clumsy because of weakness. 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 with new injected stem cells, nourish nerves, regulate his immune system and improve blood circulation. This was done with rehabilitation training.
Post-treatment:
After 14 days treatment he spoke clearer and louder, his right arm and leg muscle power increased. The right arm muscle power was increased 20%, right hand grip force was increased 20%, muscle power of the legs was also increased by 20%. His limbs were now more flexible and he walked better.
