Tarek Mohamed-Spinal Cord Injury-(Australia)

Name: Tarek Mohamed
Sex: Male
Nationality: Australia
Age: 29Y
Diagnosis: Spinal Cord Injury
Discharge Date: 2019/12/15

Before treatment:
The patient was injured and in a coma due to a plane accident in October 2018 and then underwent craniocerebral and lumbar surgery. The facial and arm function recovered after the operation but the sensation and movement of both legs were lost and urinary incontinence was found. After 5 months of rehabilitation training the motor sensory function of the lower extremities did not recover. At present the patient can turn over, get up and transfer into wheelchairs depending on his arm strength.
The patient has mood swings, used antidepressants but then stopped using them 3 months ago. He has a regular diet and sleep, needs an enema for defecation every day, can urinate with the help of bladder stomaurine, has good sleep and has lost 12 kg in weight.

Admission PE:
Bp: 109/72mmHg, pulse rate: 84/min, breathing rate: 18/min, body temperature: 36.5 degrees. The patient has good nutrition, no yellow stains or bleeding spots of the skin or mucosa, a symmetrical chest, clear respiratory sounds of both lungs, no rales heard, strong heart sounds, regular heart rhythm and no obvious murmur heard of various valves. He has a flat and soft abdomen, cystostomy opening seen at lower abdomen without red swelling or exudate, drumming sounds from percussion, no tenderness, normal liver and spleen, no edema but  poor muscle volume of the legs.

Nervous System Examination:
Patient was alert, had clear speech, normal calculation, memory and  orientation abilities. He had equal and round pupils with a diameter of 3mm, reacting sensitively to light and with free eyeball movement. He had a symmetrical forehead wrinkle, tongue was in the middle when extended, no skew when showing his teeth, normal neck movement, strong neck-turning and a strong shrug. With grade 5 muscle power of both arms, grade 0 muscle power of the legs, normal muscle tone of the arms, decreased muscle tone of both legs. He had normal deep and superficial sensation above T10, almost no deep and superficial sensation under T10, no knee tendon reflex and heel tendon reflex, negative ankle clonus and no abdominal reflex. He had a negative Rossilimo sign, Hoffmann sign and Babinski sign bilaterally, normal coordination of the arms, the coordination test of the legs was unfinished due to the muscle problem and the was a  negative meningeal irritation sign.

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, improve body environment, regulate his immune system and improve blood circulation. This was combined with rehabilitation training.   

After 14 days treatment the bilateral abdominal reflex can be induced, superficial and deep sensation appeared at T11, T12. There was normal anterior superior iliac spine of T12, left side muscle power increased to 1+ level from 0 level, he could now bend his knees and hips, use his heels to support himself on the bed, could control thighs and move side to side. Both  his sensation and motor functions increased 20%. 

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