Amyotrophic Lateral Sclerosis, Emergency Medicine

Richard S. Krause Reviewed 06/2017
 


Basics

Description

  • Progressive, incurable disease of adults

  • Neurodegenerative disease of the motor system at all levels

  • Some patients have associated dementia

  • Manifestations:

    • Muscle weakness

    • Wasting

    • Fascicul...

Diagnosis

Signs and Symptoms

  • Asymmetric limb weakness is the most common presentation of ALS (80%)

  • May begin in either the arms (cervical onset) or the legs (lumbar onset):

    • Later all limbs are affected

  • Bu...

Treatment

  • There is no specific therapy for ALS

  • The drug riluzole, a glutamate release inhibitor, has been shown to extend survival in ALS patients for an average of a few months

  • Treatment issues in the ...

Follow-Up

Disposition

Admission Criteria

  • Need for respiratory support

  • Dehydration

  • Unable to be cared for at home owing to progression of illness

  • Complications (e.g., infection) or other diagnosis that requ...

Pearls and Pitfalls

  • ALS is a progressive neurodegenerative disease affecting all components of the motor system

  • Many patients with ALS have advanced directives—inquire prior to any aggressive intervent...

Additional Reading

  • EFNS Task Force on Diagnosis and Management of Amyotrophic Lateral Sclerosis, Andersen  PM, Abrahams  S, et al. EFNS guidelines on the clinical management of amyotrophic lateral scl...

Codes

ICD9

335.20 Amyotrophic lateral sclerosis 

ICD10

G12.21 Amyotrophic lateral sclerosis 

SNOMED

  • 86044005 Amyotrophic lateral sclerosis (disorder)

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