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Sent on Saturday, 2007 Jun 23
Search (palliative care OR terminal care OR hospice care OR hospice OR "end of life" OR advance directives OR withholding treatment OR bereavement OR grief) AND ("Ann Intern Med"[Journal] OR "Arch Intern Med"[Journal] OR "BMJ"[Journal] OR "Br Med J"[Journal] OR "Br Med J (Clin Res Ed)"[Journal] OR "CMAJ"[Journal] OR "JAMA"[Journal] OR "Lancet"[Journal] OR "J Lancet"[Journal] OR "N Engl J Med"[Journal] OR "Postgrad Med"[Journal] OR "Postgrad Med J"[Journal])

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1: Lancet. 2007 Jun 16;369(9578):2031-41. Related Articles, LinkOut
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Amyotrophic lateral sclerosis.

Mitchell JD, Borasio GD.

Motor Neurone Disease Care and Research Centre, Royal Preston Hospital, Fulwood, Preston PR2 9HT, UK\. Douglas.Mitchell@lthtr.nhs.uk

Amyotrophic lateral sclerosis (known in the UK as motor neuron disease) is a devastating illness with uncertain pathogenesis\. In this Seminar, we review its natural history, clinical features, diagnostic criteria, variant and mimic syndromes, genetic forms, and epidemiology\. Several hypotheses about causes of the disorder are discussed, such as excitotoxicity and oxidant stress, and we review past and present putative disease-modifying treatments\. Disease-management strategies, from telling the patient about their illness to end-of-life decisions and palliative care, are presented\. We review options for control of the main symptoms of amyotrophic lateral sclerosis--including dysphagia, dysarthria, respiratory distress, pain, and psychological disorders--and care in the terminal phase\. The need for good psychosocial and spiritual care of patients and families is emphasised\. We conclude with an overview of some current major issues and future prospects, ranging from the search for disease markers to challenging developments such as stem-cell and gene therapy.

Publication Types:
  • Research Support, Non-U.S. Gov't

PMID: 17574095 [PubMed - in process]


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