New insights in the diagnosis and treatment of amyotrophic lateral sclerosis

Czech version

Authors: I. Štětkářová ¹; R. Matěj ^2,3; E. Ehler ⁴
Authors‘ workplace: Neurologická klinika 3. LF UK a FNKV, Praha ¹; Oddělení patologie a molekulární medicíny, Thomayerova nemocnice, Praha ²; Ústav patologie, 3. LF UK a FNKV, Praha ³; Neurologická klinika FZS UP a Pardubické krajské nemocnice, a. s. ⁴
Published in: Cesk Slov Neurol N 2018; 81(5): 546-554
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2018546

Overview

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of increased prevalence with age. The main findings are loss of peripheral and central motoneurons and their pathways with extraocular and sphincter muscle sparing. These are classical forms of ALS with loss of central and peripheral motoneurons, as well as progressive bulbar paralysis with impairment of bulbar muscles. Progressive muscle atrophy with only peripheral motoneuron lesions and primary lateral sclerosis with only central motoneuron involvement are rarely found. There are some forms of ALS associated with dementia (frontotemporal lobar dementia-motor neuron disease [FTLD-MND]) with behavioral changes, cognitive and executive dysfunction. The cause of ALS has not yet been elucidated. It is a chain of follow-up events, at the end of which is cell death in selective subpopulations of neurons. In the present paper, we describe in detail the neuropathological findings and molecular genetic analysis in familial forms of ALS. A specific drug for this disease is still unknown. Neuroprotective drugs (such as riluzole and recently edaravon) have an ambiguous effect. Symptomatic treatment is designed to manage concomitant manifestations. Different treatment options are discussed in detail.

Key words:
amyotrophic lateral sclerosis – ALS – neurophysiology – motoneuron lesion – riluzole – edaravone

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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