Case No 4: Motor Nerve Degenaration at Anterior Horn Cell level of five and a half years duration.

Mr. Ponkshe a 35 years old male presented in Oct ’92 with the following complaints:

1. Inability to walk without support due to weakness in lower limbs.
2. Severe imbalance while standing, walking and climbing.
3. Inability to sit in one posture for long.
4. Strain in leg muscles while climbing, jogging or swimming.
5. Tingling and numbness in fingers and toes.
6. Feeling of tightness in the abdomen.

He was seen and investigated by a neurologist in 1992 and diagnosed to have Vit. B12 deficiency induced myelo-neuropathy. He took Vit. B12 injections for nearly six months with only slight improvement, though memory returned to normal.

He was seen by another neurologist in Feb’94 , when the above complaints still persisted. The neurological examination revealed spastic paraparesis with hyparesthesia in the distal four limbs. Position sense was impaired in left lower limb. Vibration sense was impaired in both lower limbs. NCV studies in Feb’94 revealed - evidence of motor nerve degeneration in muscles supplied by L4-L5-S1 roots, at root or anterior horn cell level. Delayed H-reflexes also suggested a proximal lesion, no sensory neuropathy. NCV was repeated in April’98 which showed no significant change as compared to the previous record of Feb ’94. Thus there was no change in NCV during the period of four years confirming a chronic anterior horn cell or a proximal lesion.

Neuro G-Therapy was started by the patient in May ’98 and he started observing improvements from fifth week of Therapy. There were marked improvements in all the complaints enumerated above except for the vague tightness in the abdominal muscles. NCV done in June’98 showed improved EMG of right lower limb, and increase in number of motor units in left lower limbs as compared to the report of April’98. The patient continued to take Neuro G-Therapy and NCV studies of Sep’98 and Jan’99 showed a normal electro-physiological study for both lower limbs. Today the patient is totally confident while walking, climbing and driving with occasional mild numbness in fingers and toes.