title: [Amyotrophic lateral sclerosis: management of bulbar symptoms].
abstract: Symptomatic treatment of amyotrophic lateral sclerosis (ALS) is relevant in preventing complications and improving quality of life as long as curative therapies are still out of sight. About one third of ALS patients show disabling problems associated with dysarthria, dysphagia, sialorrhea, and a pseudobulbar affective disorder already in the early stages of ALS. A multidisciplinary approach is the cornerstone of symptomatic treatment of bulbar and pseudobulbar ALS features. Except for riluzole randomized controlled trials are lacking. Here, we review the current views with regard to epidemiology, pathophysiology, diagnosis, and practical aspects of treating bulbar and pseudobulbar symptoms.
authors.affiliation: Neurologische Klinik und Poliklinik Würzburg mit Neuromuskulärem Zentrum, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland. kraft_p1@klinik.uni-wuerzburg.de
authors.forename: P
authors.initials: P
authors.lastname: Kraft
authors.forename: M
authors.initials: M
authors.lastname: Beck
authors.forename: A
authors.initials: A
authors.lastname: Grimm
authors.forename: C
authors.initials: C
authors.lastname: Wessig
authors.forename: K
authors.initials: K
authors.lastname: Reiners
authors.forename: K V
authors.initials: KV
authors.lastname: Toyka
mesh_terms: D000342:Affective Symptoms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003143:Communication Devices for People with Disabilities; D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004401:Dysarthria / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team; D020828:Pseudobulbar Palsy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D019782:Riluzole / Q000627:therapeutic use; D012798:Sialorrhea / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000928:Antidepressive Agents; D018691:Excitatory Amino Acid Antagonists; D019782:Riluzole
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