Dalal Gasem Mohammad Alsharhan-Multiple Sclerosis-(Saudi Arabia)

Name: Dalal Gasem Mohammad Alsharhan
Sex: Female
Nationality: Saudi Arabian
Age: 37Y
Diagnosis: 1. Multiple Sclerosis 2. Type 2 diabetes

Before treatment:
The patient felt weakness in her lower limbs 11 years ago, especially after a long walk. Her condition got worse and worse and she also had spasms and trembling in her legs.  It was hard for her to go up and down stairs. She did some tests and was diagnosed with multiple sclerosis. She used interferon for treatment but it was not effective. She was unable to speak clearly 5 years ago and at present she is lying on the bed unable to stand, sit or walk.
Her spirit is normal, her diet, sleep and defecation actions are normal. She wears diapers every day. She takes Solifenacin 5mg in the evening.

Admission PE:
Bp: 129/99mmHg, Hr: 120/min, body temperature: 36.7 degrees. The patient had normal development and good nutrition. There was no injury or bleeding spots across her skin and mucosa, no congestion in her throat and no swelling of her tonsils. Her chest was symmetrical, the breathing sound of both lungs was clear and no dry or moist rales were heard. Her heart beat was powerful with regular cardiac rhythm and no murmur was heard in the valve areas. Her abdomen was soft without masses, there was no tenderness or rebound tenderness. Her liver and spleen were normal and there was no shifting dullness. Physiological curvature existed in her spine. There was no edema in her legs.

Nervous System Examination:
She was alert and her mental status was fine. She had cerebellar speech, her memory, calculation and orientation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm and reacted well to light. There was no damage to the vision field of both eyes. Mild horizontal nystagmus was detected in both eyes and there was white exposure when both eyes were looking to the right. Bilateral forehead wrinkle and nasolabial groove were symmetrical. There was no skewness in the corner of her mouth when she showed her teeth and her tongue was in the middle. There was no muscle atrophy in her tongue and her uvula was in the middle. Her neck was able to move with ease. Her right arm development was limited (due to brachial plex injury at birth); muscle power of the left arm was grade 4; gripping power of both hands was grade 4+; muscle power of both legs was grade 2+. Her right knee joint could not open up. Muscle tone of both legs was high. Tendon reflex of both arms was normal while that of both legs was weak. Abdominal reflex was not induced. Bilateral palm-jaw reflex was positive. Bilateral Hoffmann sign and Babinski sign were positive. Bilateral ankle clonus was not induced. The four limbs had normal sense. Left finger to nose movement was not stable, bilateral rapid alternating movement and finger to finger movement were clumsy. She could not perform the Heel-knee-tibia test. The meningeal irritation sign was negative.

Treatment:
After the admission she received 3 times nerve regeneration treatment to repair her damaged nerves, replace dead nerves, nourish nerves, regulate her immune system and improve blood circulation. This was done along with rehabilitation training.     

Post-treatment:
After 17 days treatment her blood sedimentation and blood lipid was normal, heart rate and anemia was better than before. Her left arm movement was more stable, muscle tone of both legs reduced, and muscle power of her left leg reached grade 3+.