New Treatment Guidelines for ALS

Contributed by: Dennis Fortier, President, Medical Care Corporation

In the October 13 issue of Neurology, the American Academy of Neurology has published new treatment guidelines for amyotrophic lateral sclerosis (ALS), often called Lou Gehrig's disease.

The guidelines are designed to help physicians optimize the quality of life for their ALS patients. While many with ALS with succumb to the disease within 3 to 5 years, others live as long as ten years after diagnosis. For these patients in particular, much can be done to ensure overal health and comfort throughout the disease course.

A more complete summary and link to the full publication can be viewed here but the basic guidelines are as follows:

  • prescribe Riluzole, the only FDA approved drug for ALS
  • use an assisted-breathing device
  • use a feeding (PEG) tube
  • offer botulinum toxin B to treat drooling if oral medications do not help
  • consider screening for behavioral/cognition problems because such problems might affect patients’ willingness to accept suggested treatments
  • enroll early in a specialized multidisciplinary ALS clinic to optimize care
As with other neurological disorders such as Parkinson's and Alzheimer's disease, there is no cure for ALS. However, as we see across all of these diseases, we have increased our ability to manage symptoms, prolong survival, and maintain a high quality of life. One key to such success is ongoing dissemination of guidelines outlining the highest standards of care.

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