Clinical case 16
Stabilisation of secondary progressive multiple sclerosis and improved motor function
woman · Italy
Patient record
- Patient
- woman
- Country
- Italy
- Diagnosis
- multiple sclerosis, secondary progressive course, with a marked weak and ataxic paraparesis and impaired pelvic function
- Main features before treatment
- marked weakness of the legs, severely restricted walking requiring bilateral support, reduced sensation, stiffness in the limbs, impaired bladder function, reduced physical endurance
- Functional status
- independent walking limited to a few metres with bilateral support; EDSS 6.5–7.0
- Treatment given
- an individual donor cell and neuroregenerative programme
- Course after treatment
- the previous progression of the disease stopped, increased strength in the limbs, less stiffness and lower pathological tone mainly on the left, greater physical endurance
History
The first features of demyelinating disease appeared as far back as 1977. At various points there were episodes of diplopia, visual disturbance and a left-sided hemiparesis. A diagnosis of multiple sclerosis was subsequently established.
Over time the disease moved into a secondary progressive phase. By 2012–2013 a marked paraparesis of the legs had developed, with restricted independent walking and involvement of the pelvic functions.
Despite rehabilitation, her motor capacity gradually declined. The patient could move about only with bilateral support, and her walking distance shortened over time to a few metres.
By 2023 she was using a walking frame and could manage roughly 5–10 metres unaided. Objective assessment found marked weakness of the legs, particularly on hip flexion, bilaterally reduced deep sensation and significant impairment of bladder function.
Before treatment
At the time she came to us, the main functional problems were:
- marked weakness of the legs
- a bilateral paraparesis
- substantially restricted independent walking
- the need for a walking frame or bilateral support
- reduced sensation in the legs
- a sense of stiffness and impaired control of movement
- impaired bladder function
- markedly reduced physical endurance
The level of motor deficit corresponded to an EDSS of roughly 6.5–7.0, and moving about without support was severely limited.
The main aims of the programme were to stabilise a secondary progressive disease, preserve the motor reserve that remained and improve strength, tone and tolerance of physical exertion.
The programme
A personalised donor programme of cell and neuroregenerative therapy was drawn up for the patient.
The protocol included:
- therapy with mesenchymal stromal cells of donor origin
- a systemic cell component
- use of a concentrated exosome preparation
- a course of neurotherapy
The exact doses, the sequence of procedures and the technical parameters formed part of an individual internal protocol.
Course after treatment
After the programme the patient noted positive change across several of the most significant motor functions at once.
Disease stabilisation
The most important result was that the previous clinical progression stopped.
Over the follow-up period the patient no longer noticed the further steady decline in motor capacity that had accompanied the secondary progressive course of the disease.
Muscle strength
Increased strength in the limbs was noted, above all in the most functionally restricted muscle groups of the legs.
Movement came more easily, and she was better able to make active use of the motor capacity she retained.
Stiffness and muscle tone
The muscle stiffness also became less marked.
The patient noted a reduction in the pathologically raised tone, particularly in the left limbs. Movement became freer and better controlled.
Physical endurance
Physical endurance increased noticeably.
The patient was able to stay active for longer and tolerate a greater amount of exertion without the rapid exhaustion she had experienced before.
For a patient with a long-standing marked paraparesis this mattered a great deal, since it allowed her to make fuller use of the motor capacity she still had.
Outcome
After the individual donor programme the most significant results were:
- the previous clinical progression of the disease stopped;
- no further steady decline in motor function
- increased strength in the limbs;
- less stiffness
- lower pathologically raised muscle tone, mainly on the left
- improved control of movement
- greater physical endurance and tolerance of exertion.
For a patient with long-standing secondary progressive multiple sclerosis, the combination of disease stabilisation with a real improvement in motor capacity mattered particularly.
After many years of gradually narrowing mobility, the patient stopped noticing further loss of function and at the same time gained positive change in precisely the areas that mattered most to her – muscle strength, freedom of movement and physical endurance.
This case is described from the patient's medical records and observation over the period after the programme. No personal data is published. The course of the disease and the response to treatment differ from patient to patient.