title: Respiratory failure as the presenting manifestation of amyotrophic lateral sclerosis.
abstract: Although amyotrophic lateral sclerosis (ALS) does not directly affect the lung parenchyma, it can jeopardize the mechanical function of the respiratory system. About one-quarter of ALS patients have had at least one prior misdiagnosis. Therefore, a high clinical suspicion, and careful correlation of physical examination and electromyography (EMG) are needed to reach the correct diagnosis. We report a 65-year-old man who presented with a progressive exertional dyspnea. He was subsequently found to have a diaphragmatic paralysis that was felt to be secondary to spinal cord stenosis. However, his subsequent EMG showed evidence of muscle fasciculation and he was ultimately diagnosed with ALS.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Gonda 18 South, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. Electronic address: srivali.narat@mayo.edu.
authors.forename: Narat
authors.initials: N
authors.lastname: Srivali
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Gonda 18 South, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
authors.forename: Jay H
authors.initials: JH
authors.lastname: Ryu
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Gonda 18 South, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Rabatin
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000175:diagnosis*; D004576:Electromyography; D005207:Fasciculation / Q000209:etiology; D006801:Humans; D008297:Male; D012133:Respiratory Paralysis / Q000209:etiology*
keywords: Amyotrophic lateral sclerosis; Diaphragmatic paralysis; Respiratory failure