Amyotrophe Lateralsklerose - Abklärung und Therapie

Abstract

Amyotrophic lateral sclerosis (ALS) represents the most common motoneuron disorder in adulthood. It is characterized by selective degeneration of the motoneurons. About 10% of patients have a genetically determined ALS. Clinically, ALS is characterized by coexistence of signs of the first motoneuron, such as spasticity and hyperreflexia, as well as the second motoneuron, such as muscular atrophy and fasciculations. If such signs are present in at least three regions and if other possible causes have been excluded, a definite diagnosis of ALS can be made based on the revised El-Escorial criteria. Initial manifestations are often focalized and generalization develops during the course. The glutamate antagonist riluzole is worldwide the only approved ALS treatment. However, symptomatic treatments to ameliorate spasticity, drooling, speech and swallowing problems, and assisted ventilation to treat respiratory failure are essential.

Botulinum Toxin Type A and Physiotherapy in Spasticity of the Lower Limbs Due to Amyotrophic Lateral Sclerosis

“…Clinically, patients show signs of II motor neuron damage with flabby paralysis (claw hand), areflexia, muscular atrophy, and muscle fasciculations; thus, muscular weakness and atrophy appear. Dysphagia, dysarthria, and dysphonia appear when cranial nerves are involved [13]. Furthermore, I and II motor neuron loss causes fatal paralysis and death [4,14].…”