Title

The Care of the Patient with Amyotrophic Lateral Sclerosis: Drug, Nutritional, And Respiratory Therapies

Authoring Organization

American Academy of Neurology

Publication Month/Year

October 1, 2009

Last Updated Month/Year

October 17, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

To systematically review evidence bearing on the management of patients with amyotrophic lateral sclerosis (ALS).

Target Patient Population

Patients with amyotrophic lateral sclerosis

PICO Questions

  1. Does lithium carbonate prolong survival or slow disease progression in amyotrophic lateral sclerosis?

  2. What is the effect of riluzole on slowing the disease process or prolonging survival in amyotrophic lateral sclerosis?

  3. What is the effect of enteral nutrition administered via Percutaneous Endoscopic Gastrostomy on weight stability?

  4. When is Percutaneous Endoscopic Gastrostomy indicated in amyotrophic lateral sclerosis?

  5. What is the efficacy of nutritional support via Percutaneous Endoscopic Gastrostomy in prolonging survival?

  6. What is the effect of enteral nutrition delivered via Percutaneous Endoscopic Gastrostomy on quality of life?

  7. What is the efficacy of vitamin and nutritional supplements on prolonging survival or quality of life?

  8. What are the optimal pulmonary tests to detect respiratory insufficiency?

  9. Does Non-invasive ventilation improve respiratory function or increase survival?

  10. How do invasive and noninvasive ventilation affect quality of life?

  11. What factors influence acceptance of invasive and noninvasive ventilation?

  12. What is the efficacy of targeted respiratory interventions for clearing secretions?

Inclusion Criteria

Male, Female, Adult

Health Care Settings

Ambulatory, Hospital, Outpatient

Intended Users

Dietician nutritionist, nurse, nurse practitioner, occupational therapist, physician, physician assistant, respiratory therapist

Scope

Assessment and screening, Treatment, Management

Diseases/Conditions (MeSH)

D000690 - Amyotrophic Lateral Sclerosis, D019636 - Neurodegenerative Diseases

Keywords

amyotrophic lateral sclerosis, neurodegenerative disease

Source Citation

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. R. G. Miller, C. E. Jackson, E. J. Kasarskis, J. D. England, D. Forshew, W. Johnston, S. Kalra, J. S. Katz, H. Mitsumoto, J. Rosenfeld, C. Shoesmith, M. J. Strong, S. C. Woolley. Neurology Oct 2009, 73 (15) 1218-1226; DOI: 10.1212/WNL.0b013e3181bc0141