Electromyography shows fibrillation and fasciculations. The motor units are polyphasic and have high amplitude and long duration. When diagnosis is unclear, perform CT scans and contrast myelography to visualize the cervical spine. Be familiar with ALS and entertain the diagnosis in patients presenting with upper and lower motor signs. Manage symptoms and ensure that emotional support is available to patients and their families.
Denial is common in the early stages of the disease.
Manage these problems with appropriate antibiotics and supportive therapy. Refer patients to a neurologist in a timely manner. Consider consultation with a pulmonologist or intensivist for follow-up with patients on a home ventilator. No treatment influences the disease process. Copious oral secretions do not respond to atropine.