Amyotrophic Lateral Sclerosis by Hiroshi Mitsumoto MD

By Hiroshi Mitsumoto MD

Amyotrophic Lateral Sclerosis provides the main entire, clinically-focused info on ALS (Lou Gehrig's affliction) in print. the 3 authors, well known for his or her paintings during this zone, supply cohesive and balanced assurance of this syndrome, together with the heritage, scientific gains, pathology and pathogenesis, remedy and administration of ALS. To facilitate knowing, every one bankruptcy is greater through complete tables and figures, in addition to certain bankruptcy summaries.

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19 Age is the most significant risk factor for ALS,92,107,139 although genetic predisposition is also important (see Chapter 10). In addition, the duration of ALS appears to be age-related, with survival being approximately three times longer in patients with onset age less than 41 years compared to those with onset age over 60 years38 (see Chapter 9). * With increasing age, the proportions of male and female ALS patients over 65 years of age become more equal (see Fig. 19,86,131 However, bulbaronset ALS has been reported to be more fre*References 16,37,47,62,65,84,87,94,111,135,140 quent in women than in men in some,25,113 but not all,131 studies.

ALS is the most common motor neuron disease of undetermined cause in adults. Diagnosis requires evidence of widespread upper motor neuron (UMN) and lower motor neuron (LMN) involvement. At onset, however, ALS may present exclusively with LMN signs, in which case it may be called LMNonset ALS or the progressive muscular atrophy (PMA) form of ALS. If UMN signs develop during the disease course, the disease, by definition, becomes ALS. Similarly, when ALS presents solely with UMN signs, it may be called UMN-onset ALS or the primary lateral sclerosis (PLS) form.

Finger, S: Origin of neuroscience. A history of explorations into brain function. Oxford University Press, New York, 1994. 24. Fromann, M: Atrophie musculaire progressive (autopsie). Med Chir Mschr 1 (1858) summary in Arch Gen Med 13:96, 1859. 25. Gajdusek, DC: Motor-neuron disease in native of New Guinea. N Engl J Med 268:474-476, 1963. 26. Gajdusek, DC and Salazar, AM: Amyotrophic lateral sclerosis and parkinsonian syndromes in high incidence among the Auyu and Jakai people of West New Guinea.

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