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{{Amyotrophic lateral sclerosis}}
{{Amyotrophic lateral sclerosis}}
{{CMG}}{{AE}}{{MMJ}}
{{CMG}}{{AE}}{{MMJ}}
==Overview==
==Natural History, Complications, and Prognosis==
===Natural History===


==Overview==
*The symptoms of Amyotrophic lateral sclerosis usually develop in the fifth decade of life.
Regardless of the part of the body first affected by the disease, it is usual for [[muscle weakness]] and [[atrophy]] to spread to other parts of the body as the disease progresses. It is important to remember that some patients with ALS have an arrested course with no progression beyond a certain point despite extensive follow-up. Such a pattern is particularly true for young males with predominant upper limb [[weakness]] especially on one side (so-called monomelic or Hirayama type mother neuron disease). Eventually people with ALS will not be able to stand or walk, get in or out of bed on their own, or use their hands and arms. In later stages of the disease, individuals have difficulty breathing as the muscles of the respiratory system weaken. Although ventilation support can ease problems with breathing and prolong survival, it does not affect the progression of ALS. Most people with ALS die from [[respiratory failure]], usually within 3 to 5 years from the onset of symptoms. However, about 10 percent of those individuals with ALS survive for 10 or more years.
*Only 5% of the cases have an onset <30 years of age.
 
===Complications===
*Common complications of [disease name] include:
**[Complication 1]
**[Complication 2]
**[Complication 3]


==Prognosis==
===Prognosis===
*Although the sequence of emerging symptoms and the rate of disease progression vary from person to person, eventually patients will not be able to stand or walk, get in or out of bed on their own, or use their hands and arms.
*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
*Difficulty swallowing and chewing impair the patient's ability to eat normally and increase the risk of choking.
*Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
*Maintaining weight will then become a problem.
*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
*Because the disease usually does not affect cognitive abilities, patients are aware of their progressive loss of function and may become anxious and depressed.
*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
*A small percentage of patients go on to develop [[frontotemporal dementia]] characterized by profound personality changes; this is more common among those with a family history of [[dementia]].
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
*A larger proportion of patients experience mild problems with word-generation, attention, or decision-making. Cognitive function may be affected as part of the disease process or could be related to poor breathing at night (nocturnal [[hypoventilation]]). Health care professionals need to explain the course of the disease and describe available treatment options so that patients can make informed decisions in advance.
*As the diaphragm and [[intercostal muscle]]s (rib cage) weaken, [[forced vital capacity]] and inspiratory pressure diminish. In bulbar onset ALS, this may occur before significant limb weakness is apparent. Bilevel positive pressure ventilation (frequently referred to by the tradename [[BiPAP]]) is frequently used to support breathing, first at night, and later during the daytime as well.
*It is recommended that long before [[BiPAP]] becomes insufficient, patients (with the eventual help of their families) must decide whether to have a [[tracheostomy]] and long term mechanical ventilation. Most patients do not elect this route, and instead choose [[Palliative care|palliative hospice care]] at this point. Most people with ALS die of respiratory failure or [[pneumonia]], not the disease itself.
*ALS predominantly affects the motor neurons, and in the majority of cases the disease does not impair a patient's mind, personality, intelligence, or memory. Nor does it affect a person's ability to see, smell, taste, hear, or feel touch.
*Control of eye muscles is the most preserved function, although some patients with an extremely long duration of disease (20+ years) may lose eye control too. Unlike [[multiple sclerosis]], bladder and bowel control are usually preserved in ALS, although as a result of immobility and diet changes, intestinal problems such as constipation can require intensive management.


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 


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[[Category: (name of the system)]]
[[Category:Needs content]]
[[Category:Motor neuron disease]]
[[Category:Neurology]]
[[Category:Disease]]
[[Category:Needs overview]]

Revision as of 15:36, 16 October 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of Amyotrophic lateral sclerosis usually develop in the fifth decade of life.
  • Only 5% of the cases have an onset <30 years of age.

Complications

  • Common complications of [disease name] include:
    • [Complication 1]
    • [Complication 2]
    • [Complication 3]

Prognosis

  • Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
  • Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
  • The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
  • [Subtype of disease/malignancy] is associated with the most favorable prognosis.
  • The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.

References

Template:WH Template:WS

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