The Care of the Patient with Amyotrophic Lateral Sclerosis: Drug, Nutritional, And Respiratory Therapies
Key Points
Key Points
- Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive, paralyzing, neurodegenerative disease. It is characterized by loss of motor neurons in the spinal cord, brainstem, and motor cortex.
- Most patients with ALS die within 2 to 5 years of onset.
- The mainstay of ALS management is symptomatic treatment and palliative care.
- Riluzole has FDA approval for slowing disease progress in ALS.
- Multidisciplinary clinics are the optimal means to coordinate ALS treatment.
Figure 1. Algorithm for Respiratory Management
Assessment and Diagnosis
...As...
...ognitive and behavioral impairment should...
...ts of executive function may be considered to...
...ere are insufficient data to support or refut...
...re is insufficient evidence to support...
...re 2. Algorithm for Nutrition Manag...
Selecting a Treatment Regimen
...Selecting a...
...iluzole should be offered to slow disease p...
...loping fatigue while taking riluzole,...
...ere are insufficient data at this time to support...
...have medically refractory sialorrhea, botulin...
...adiation therapy to the salivary glands may...
...seudobulbar AffectIf approved by the...
...amps/Spastic...
...here are insufficient data to support or refute an...
...are insufficient data to support or refute e...
...Nutrition Manage...
...impaired oral food intake, enteral nu...
...here are insufficient data to support or refute s...
...nsidered for prolonging survival. (...
...owever, there are insufficient data to support...
...tine, in doses of 5-10 g daily, should NOT be...
...se vitamin E should NOT be considered as treatme...
while the equivocal evidence regarding low...
...ease Management...
...multidisciplinary clinic referral should b...
...d may be considered to enhance qualit...
...Respira...
...Assessment:...
Supine forced vital capacity (FVC) and...
...ximetry may be considered to detect hypoven...
...nasal pressure (SNP) may be consider...
...Treatme...
...tilation should be considered to treat r...
...asive ventilation may be considered to enh...
...nvasive ventilation may be considered at...
...my invasive ventilation (TIV) may be...
...nical insufflation/exsufflation (MIE)...
...e are insufficient data to support...
...There are insufficient data to sup...
...1. FDA-Approved Drugs for ALSHaving trouble vi...