Amyotrophic lateral sclerosis - Revision history

Rossdonaldson1 at 17:50, 12 October 2022

2022-10-12T17:50:46Z

← Older revision		Revision as of 17:50, 12 October 2022
Line 7:		Line 7:
	==Clinical Features==		==Clinical Features==
	[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness.]]		[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness.]]
	[[File:ALS clinical picture.png\|thumb\|A man with amyotrophic lateral sclerosis (ALS). (A) He needs assistance to stand. (B) Advanced atrophy of the tongue. (C) There is upper limb and truncal muscle atrophy with a positive Babinski sign. (D) Advanced thenar muscle atrophy.]		[[File:ALS clinical picture.png\|thumb\|A man with amyotrophic lateral sclerosis (ALS). (A) He needs assistance to stand. (B) Advanced atrophy of the tongue. (C) There is upper limb and truncal muscle atrophy with a positive Babinski sign. (D) Advanced thenar muscle atrophy.]]
	*Acute [[respiratory failure]]		*Acute [[respiratory failure]]
	**Predicted by forced VC <25 mL/kg or 50% decrease from normal		**Predicted by forced VC <25 mL/kg or 50% decrease from normal
Line 35:		Line 35:

	===Imaging===		===Imaging===
	*CXR		*[[CXR]]
	**May identify aspiration, pneumonia, or other comorbid conditions		**May identify aspiration, pneumonia, or other comorbid conditions

2022-10-12T17:49:53Z

Clinical Features

← Older revision		Revision as of 17:49, 12 October 2022
Line 7:		Line 7:
	==Clinical Features==		==Clinical Features==
	[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness.]]		[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness.]]
			[[File:ALS clinical picture.png\|thumb\|A man with amyotrophic lateral sclerosis (ALS). (A) He needs assistance to stand. (B) Advanced atrophy of the tongue. (C) There is upper limb and truncal muscle atrophy with a positive Babinski sign. (D) Advanced thenar muscle atrophy.]
	*Acute [[respiratory failure]]		*Acute [[respiratory failure]]
	**Predicted by forced VC <25 mL/kg or 50% decrease from normal		**Predicted by forced VC <25 mL/kg or 50% decrease from normal

2021-07-25T04:12:35Z

External Links

← Older revision		Revision as of 04:12, 25 July 2021
Line 61:		Line 61:

	==External Links==		==External Links==
			*[https://www.merckmanuals.com/professional/neurologic-disorders/peripheral-nervous-system-and-motor-unit-disorders/amyotrophic-lateral-sclerosis-als-and-other-motor-neuron-diseases-mnds?query=amyotrophic%20lateral%20sclerosis Merk Manual - Amyotrophic Lateral Sclerosis (ALS) and Other Motor Neuron Diseases (MNDs)]
			*[http://www.emdocs.net/amyotrophic-lateral-sclerosis-focused-emergency-medicine-review/ emDOCs - Amyotrophic Lateral Sclerosis: A Focused Emergency Medicine Review]

	==References==		==References==

2021-07-25T04:08:44Z

Disposition

← Older revision		Revision as of 04:08, 25 July 2021
Line 49:		Line 49:

	==Disposition==		==Disposition==
			*'''Admission'''
			**Admit if patient requires respiratory support or has other complications requiring admission
			**Evaluate patient's ability to be cared for at home; admit if needed
			*'''Discharge'''
			**If stable, and new onset ALS is suspected, discharge with a referral for outpatient evaluation by neurologist
			**If stable, and ALS has previously been diagnosed, discharge if outpatient treatment remains available for patient

	==See Also==		==See Also==

2021-07-25T03:55:05Z

Evaluation

@@ Line 18: / Line 18: @@
 ==Evaluation==
 [[File:ALS cross.jpg|thumb|MRI (axial FLAIR) demonstrates increased T2 signal within the posterior part of the internal capsule, consistent with the diagnosis of ALS.]]
 ==Management==

2020-10-24T10:03:38Z

References

← Older revision		Revision as of 10:03, 24 October 2020
Line 35:		Line 35:
	==References==		==References==
	<references/>		<references/>
	Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e (2010), Chapter 167. Chronic Neurologic Disorders		*Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e (2010), Chapter 167. Chronic Neurologic Disorders

	[[Category:Neurology]]		[[Category:Neurology]]

2020-10-24T10:03:18Z

Clinical Features

← Older revision		Revision as of 10:03, 24 October 2020
Line 6:		Line 6:

	==Clinical Features==		==Clinical Features==
	[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness]].		[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness.]]
	*Acute [[respiratory failure]]		*Acute [[respiratory failure]]
	**Predicted by forced VC <25 mL/kg or 50% decrease from normal		**Predicted by forced VC <25 mL/kg or 50% decrease from normal

2020-10-24T10:02:59Z

Clinical Features

← Older revision		Revision as of 10:02, 24 October 2020
Line 6:		Line 6:

	==Clinical Features==		==Clinical Features==
			[[File:Using a head mounted laser to point to a communication board.jpg\|thumb\|A man with ALS using a head-mounted laser pointer to comunicate. Note asymetic motor weakness]].
	*Acute [[respiratory failure]]		*Acute [[respiratory failure]]
	**Predicted by forced VC <25 mL/kg or 50% decrease from normal		**Predicted by forced VC <25 mL/kg or 50% decrease from normal

2020-10-24T10:00:02Z

Evaluation

← Older revision		Revision as of 10:00, 24 October 2020
Line 16:		Line 16:

	==Evaluation==		==Evaluation==
			[[File:ALS cross.jpg\|thumb\|MRI (axial FLAIR) demonstrates increased T2 signal within the posterior part of the internal capsule, consistent with the diagnosis of ALS.]]

	==Management==		==Management==

2020-10-24T09:59:02Z

← Older revision		Revision as of 09:59, 24 October 2020
Line 14:		Line 14:
	==Differential Diagnosis==		==Differential Diagnosis==
	{{Weakness DDX}}		{{Weakness DDX}}

			==Evaluation==

	==Management==		==Management==
	#Nebulized medications		*Nebulized medications
	#[[Steroids]]		*[[Steroids]]
	#[[Antibiotics]] for infectious complications		*[[Antibiotics]] for infectious complications
	#Assisted ventilation / intubation if in [[respiratory failure]] and aligned with [[goals of care]]		*Assisted ventilation / intubation if in [[respiratory failure]] and aligned with [[goals of care]]

			==Disposition==

	==See Also==		==See Also==
	*[[Weakness]]		*[[Weakness]]
	*[[Intubation]]		*[[Intubation]]

			==External Links==

	==References==		==References==