Palliative care in amyotrophic lateral sclerosis.
The poor prognosis of amyotrophic lateral sclerosis (ALS) makes palliative care a challenge for the neurologist. Most disabilities associated with progressive disease can be ameliorated by symptomatic treatment. Prognosis and treatment options should be openly discussed with the patient and his/her relatives. Nutritional deficiency due to pronounced dysphagia can be efficiently relieved by a percutaneous enterogastrostomy. Respiratory insufficiency can be treated by non-invasive ventilation at home, provided the familial environment is supportive. Adequate assistance and palliative treatment in the terminal phase is of paramount importance.
Borasio
G D
GD
Department of Neurology, University of Munich, Klinikum Groflhadern, Munich, Germany.
Voltz
R
R
D016223:Advance Directives; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000523:psychology / Q000628:therapy*; D001007:Anxiety / Q000517:prevention & control; D003128:Coma / Q000209:etiology; D003680:Deglutition Disorders / Q000628:therapy; D004401:Dysarthria / Q000534:rehabilitation / Q000628:therapy; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D005774:Gastrostomy / Q000523:psychology; D006801:Humans; D006935:Hypercapnia / Q000209:etiology; D009748:Nutrition Disorders / Q000517:prevention & control; D010166:Palliative Care; D010817:Physician-Patient Relations; D012138:Respiratory Therapy; D012952:Societies; D013727:Terminal Care; D014342:Truth Disclosure