ALS Flashcards
what is ALS
- adult onset
- prgoressive NM disease
- muscle wasting
- sclerosis
- UMN and LMN
-most physically devastinging disease
what are some characteristics of ALS
-difficulty wtih language comprehension
attention
planning
abstract reasoning
what is the diagnosis of ALS
UMN/LMN in 3 regions
EMG
what is the prognosis
earlier onset (younger than 50) has a longer course -adult sporadic onset results in death 2-5 years from pneumoina and inability to eat
what is staging 0
kings= presymptomatic
MITOS: functional involvement/disease onset
what is staging 1
kings= invovlement of 1 clinical region
MITOS: loss of independence in 1 functional domain
what is staging 2
kings= invovlement of 2 clinicl regions
MITOS: loss of independence in 2 domains
what is staging 3
kings= inovlvement in 3 clinicla regions
MITOS: loss of independence in 3 domains
what is staging 4
kings= substantial respiratory or nutritional failure MITOS= loss of independence in 4 domains
what is staging 5
both= death
what does exam history include
- location of symptom onset
- year of onset
- date of diagnosis
- previous trauma
- falls secondary to weakness
- laminectomies
- carpal tunnel
what is bulbar ALS
- inability to hold eye closed against pressure
- dysarthria
- inability to swallow
- decreased tongue movement
- droolikng
- fasciultations
what are LMN symptoms
flaccid
fasciculations of tongue
what are UMN symtoms
lack of dexterity
spasticity
decrased strength
hyperreflexiaq
what is preserved throuhgout the course of ALS
eye movements
sensory
bowel and bladder function
what is PT for early stages
- aerobic and moderate exercise
- AD
- discourage exercises with hypertrophy goal
- gentle ressitance
- ROM and stretching
what are some risk factors
- older age
- low BMI
- smoking
- professional athletes
- repeated head injuries
what is the incidence
2x in white
male more than female
-increases after age 40
-peaks age 65-70
what is the pathology
- dysfunction of astrocytic excitatory amino transporter
- reduced uptake of gluteamate
what is amyotrophy
loss of brainstem CN nuceli and anterior horn cells in spinal cord
what is lateral sclerosis
loss of cortical motor cells causing corticospinal tract dysfunction
what is the el escorial critera
- evidence of LMN degeneration
- evidence of UMN degeneration
- progression of motor syndrome
what are negative prognositc factors
- bulbar onset
- weight loss
- cognitive impairment
- impaired respiratory function
