Amyotrophic lateral sclerosis

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Background

  • Progressive muscle atrophy/weakness due to degeneration of upper and lower motor neurons
  • Pts will rarely present to the ED undiagnosed

Clinical Features

  • Acute respiratory failure
    • Predicted by forced VC <25 mL/kg or 50% decrease from normal
  • Aspiration pneumonia
  • Trauma related to extremity weakness

Management

  1. Nebulized medications
  2. Steroids
  3. Antibiotics
  4. Assisted ventilation / intubation

Source

Tintinalli

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