Amyotrophic Lateral Sclerosis: Diagnosis and Appropriate Management

CONCLUSION

The exact cause or causes of ALS remain unknown, making it difficult to predict who will present with a disease that appears impossible to prevent. Health care providers in any practice should be aware of the signs of ALS and familiar with its symptoms in order to provide optimal management for potentially affected patients.

Any cause for suspicion of ALS (ie, recent-onset limb weakness or atrophy; difficulty swallowing or speaking) warrants immediate patient referral to a neurologist. Evaluation should include a comprehensive history and physical examination, with emphasis on the musculoskeletal and neurologic exams; MRI of the spine and head, analysis of blood and CSF samples, EMG, and nerve conduction studies should be used to rule out treatable causes of limb weakness.

Potential complications of ALS, including nutritional deficiency, respiratory compromise, and depression, should be discussed early with patients and their caregivers. Management of the patient with ALS necessitates a multidisciplinary approach involving providers from several specialties to ensure that the many issues associated with this disease are being addressed. The priority of the health care provider should be to extend the patient’s survival while maintaining quality of life.