Amyotrophic Lateral Sclerosis: A Guide for Patients and by Hiroshi Mitsumoto MD

By Hiroshi Mitsumoto MD

This significant publication covers each point of dwelling with ALS, from medical positive factors of the ailment to an summary of symptom administration to figuring out its prognosis. significant sections care for overseeing remedy and rehabilitation, dwelling with ALS, the disease’s complex section, end-of-life concerns, and assets. largely revised and rewritten, this version comprises new chapters at the most recent techniques to treating ALS indicators, using noninvasive ventilators, multidisciplinary crew care, new instructions being built through the yank Academy of Neurology for sufferers with ALS, using riluzole (Rilutek), and extra.

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Extra resources for Amyotrophic Lateral Sclerosis: A Guide for Patients and Families

Sample text

17. Camu W, Cadilhac J, Billiard M. Amyotrophic lateral sclerosis: a report on two couples from southern France. Neurology. 1994;44:547–548. 18. Estrin WJ. Amyotrophic lateral sclerosis in dizygotic twins. Neurology. 1977;27:692– 694. 19. Sienko DG, Davis JP, Taylor JA, et al. Amyotrophic lateral sclerosis: a case-control study following detection of a cluster in a small Wisconsin community. Arch Neurol. 1990;47:38–41. 20. Melmed C, Krieger C. A cluster of amyotrophic lateral sclerosis. Arch Neurol.

The entire group of muscle fibers innervated by one motor neuron is called the motor unit. The muscle fibers in one motor unit are not grouped together in the muscle. Instead, they are scattered widely and intermixed with other muscle fibers that belong to many other motor units. 2). This process is called denervation. Muscle fibers that are denervated lose their ability to contract and thus waste and shrink, a process called denervation atrophy. Once the muscle fibers are denervated, nerve fibers that belong to healthy motor neurons develop “sprouts” and take over the neural control of denervated muscle fibers.

When the muscle tendon is tapped, the muscle spindle stretches and sends an excitatory impulse. In healthy people this impulse produces a typical reflex with quick muscle contraction called a monosynaptic muscle stretch reflex. When upper motor neuron control is disrupted, stretch reflexes become abnormally exaggerated because the inhibition exerted by the upper motor neurons is impaired. In pathologic hyperreflexia, only a slight or distant stimulus is needed to elicit the reflex response. For example, an ordinary tendon tap elicits reflexes in neighboring muscles (an event called spreading), and manual stretching of the muscle induces repeated, rhythmic muscle contractions called clonus.

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