Patients with progressive weight loss, symptomatic dysphagia, or aspiration should be considered for percutaneous gastrostomy placement. Advance directives should be addressed by the patient's neurologist early in the course and should be discussed at regular intervals. Hospice referral may be appropriate to aid in care during the terminal phase of the disease. Early in the treatment course, encourage patients to continue routine activities. Patients are best cared for in a designated ALS center.
Many mechanical aids can help overcome disabilities.
Younger patients may have a slower rate of progression. Patients with bulbar onset, particularly the lower motor neuron type, have a poorer prognosis. In a patient with an established diagnosis of ALS, follow advance directives. Comprehensive management of amyotrophic lateral sclerosis. Caring for patients with amyotrophic lateral sclerosis.