Management of amyotrophic lateral sclerosis

: Management Of amyotrophic lateral Sclerosis Management of amyotrophic lateral sclerosis starts with diagnosis announcement which is straightaway followed by initiating neuroprotective treatment (riluzole). A quarterly-based management is proposed, coordinated by an ALS center in close collaboration with the general practitioner, home care organization, and a dedicated health network. Key point for efficiency of global care is to develop a coordination with a multidisciplinary approach, including the involvement of neurologist and physicians from different medical specialties, nurse practitioners, physical and occupational therapists, speech language therapists, dietitians and psychologists. The assessments follow-up concern mainly motor impairments and physical disability, adaptations, nutritional and respiratory functions. Associated symptoms such as pain, spasticity, mood disorders have to be recognized and treated. Decisions about nutritional and respiratory assistive devices require a collaborative approach involving specialized practitioners and paramedical professionals. These decisions have to be anticipated (advanced directives) in agreement with the patient, the family and the trusted person. Along the disease's management, patients and their family may have support from a psychologist. Finally, home care organization requires the intervention of a social worker.