Amyotrophic Lateral Sclerosis

Amyotrophic Lateral Sclerosis: Or something else? Differential Diagnosis

Musculoskeletal system and connective tissue (M00-M99). Inclusion body myositis – neuromuscular disease; trunk-related weakness, fewer atrophies. Psyche – nervous system (F00-F99; G00-G99). Chronic inflammatory demyelinating polyneuropathy (CIDP) – weakening of muscle reflexes, protein elevation in cerebrospinal fluid (“nerve water“), pathological nerve conduction velocity. Dementia, frontal Neuropathy (multifocal, motor) Polyneuropathy (chronic, motor) Pseudobulbar paralysis – disease … Amyotrophic Lateral Sclerosis: Or something else? Differential Diagnosis

Amyotrophic Lateral Sclerosis: Complications

The following are the major diseases or complications that may be contributed to by amyotrophic lateral sclerosis (ALS): Respiratory system (J00-J99) Aspiration pneumonia (pneumonia caused by inhalation of foreign substances (often stomach contents)). Pneumonia Respiratory insufficiency (respiratory failure; disturbance of external (mechanical) respiration). Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99) Abnormal … Amyotrophic Lateral Sclerosis: Complications

Amyotrophic Lateral Sclerosis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height. If tapping the muscles or cold stimuli can induce fasciculations (involuntary movements of very small muscle groups), further diagnostic steps must be taken. Neurological examination – including strength testing, triggering reflexes, etc. … Amyotrophic Lateral Sclerosis: Examination

Amyotrophic Lateral Sclerosis: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Creatine kinase (CK, CK-MB) – may be elevated. Electrolytes – calcium, magnesium, sodium, potassium, phosphates, chloride. Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Liver parameters – alanine aminotransferase (GPT), aspartate aminotransferase (GOT). Fasting glucose (fasting blood glucose), … Amyotrophic Lateral Sclerosis: Test and Diagnosis

Amyotrophic Lateral Sclerosis (ALS): Drug Therapy

Therapeutic targets Functional improvement Relief of discomfort Life extension Therapy recommendations Causal therapy of ALS is not yet possible. Symptomatic therapy: Bulbar symptoms (concerning pharyngeal/throat muscles): methanthelinium bromide (anticholinergics); trihexyphenidyl (muscarinic receptor anatgonists); glycopyrronium (parasympatholytics). Anxiety: benzodiazepines (e.g., lorazepam). Depression (see under depression): preferential use of serotonin reuptake inhibitors (e.g., citalopram); tricyclics (e.g., amitryptiline). Hypersalivation … Amyotrophic Lateral Sclerosis (ALS): Drug Therapy

Amyotrophic Lateral Sclerosis: Diagnostic Tests

Obligatory medical device diagnostics. Electromyography (EMG; measurement of electrical muscle activity) and electroneurography (ENG; measurement of nerve conduction velocity (NLG) of motor and sensory pathways of peripheral nerves) – to detect pathologic (pathological) muscle activity, which is often combined with a decrease in motor units Magnetic resonance imaging (MRI; computer-assisted cross-sectional imaging procedure (using magnetic … Amyotrophic Lateral Sclerosis: Diagnostic Tests

Amyotrophic Lateral Sclerosis: Symptoms, Complaints, Signs

For the diagnosis of amyotrophic lateral sclerosis, the presence of clinical pathology of the 1st and 2nd motor neuron at one level is required; alternatively, for the 2nd motor neuron, electrophysiologic signs of damage at two levels are required. The following symptoms and complaints may indicate amyotrophic lateral sclerosis (ALS): Main symptoms Ataxia (gait disturbances) … Amyotrophic Lateral Sclerosis: Symptoms, Complaints, Signs

Amyotrophic Lateral Sclerosis: Causes

Pathogenesis (disease development) Motoneurons (motor nerve cells) normally transmit nerve impulses from the brain and spinal cord (= CNS, central nervous system) to the muscles of the body. Each skeletal muscle receives its nerve stimuli from two nerve cells, the 1st motoneuron (upper motoneuron) and the 2nd motoneuron (lower motoneuron). The 1st motoneuron originates in … Amyotrophic Lateral Sclerosis: Causes

Amyotrophic Lateral Sclerosis: Medical History

Medical history (history of illness) is an important component in the diagnosis of amyotrophic lateral sclerosis (ALS). Family history Are there any hereditary diseases in your family? Are there any diseases in your family that are common? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? When does this … Amyotrophic Lateral Sclerosis: Medical History

Amyotrophic Lateral Sclerosis (ALS): Therapy

Therapy for ALS should be interdisciplinary. The main focus is on occupational therapy, physiotherapy, speech therapy, psychotherapeutic support, and palliative medical measures. General measures Preservation of the patient’s autonomy, which means, among other things, early education and preparation of an advance directive. Nutritional medical measures (see below) to counteract weight loss and thus prolong the … Amyotrophic Lateral Sclerosis (ALS): Therapy