title: Emergencies in motoneuron disease.
abstract: Genetic and acquired motor-neuron-disorders (MNDs) may undergo acute deterioration resulting in various emergency situations. This literature review aims at summarising and discussing current knowledge about emergencies in MNDs. Emergencies that have been reported in MND patients include: respiratory, bulbar, cardiac, septic, epileptic, psychiatric, pain-related, and traumatic emergencies. Emergencies due to respiratory insufficiency have the strongest impact on morbidity and mortality in MNDs. To optimise the management of emergencies in MNDs, it is recommended to discuss these topics with the patient prior to their occurrence. After informed consent, patients may indicate their decision by signing an advance directive as to how such emergencies should be managed in case they arise. Generally, treatment of emergencies in MNDs is not at variance from treatment of similar emergencies due to other causes, but some peculiarities need to be pointed out. It is concluded that patients with MNDs may experience various emergencies during the disease course. Management of these conditions should be discussed with the patient prior to their appearance. Management of these emergencies follows general guidelines, which widely vary between countries, and depend on the availability of a patient's advance directive.
authors.affiliation: Krankenanstalt Rudolfstiftung, Postfach 20, 1180, Vienna, Austria. fifigs1@yahoo.de.
authors.forename: Josef
authors.initials: J
authors.lastname: Finsterer
authors.affiliation: 2nd Medical Department with Cardiology and Intensive Care Medicine, Krankenanstalt Rudolfstiftung, Vienna, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Stöllberger
mesh_terms: D000058:Accidental Falls; D010244:Bulbar Palsy, Progressive / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004630:Emergencies; D006801:Humans; D016472:Motor Neuron Disease / Q000150:complications* / Q000503:physiopathology*; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012640:Seizures / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
keywords: Anterior horn cell disease; Artificial ventilation; Emergency; Motoneuron disease; Respiratory insufficiency; Seizures; Sepsis; Takotsubo