Amyotrophic lateral sclerosis physical examination: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 2: | Line 2: | ||
{{Amyotrophic lateral sclerosis}} | {{Amyotrophic lateral sclerosis}} | ||
==Overview== | ==Overview== | ||
==Physical Examination== | ==Physical Examination== | ||
| Line 22: | Line 21: | ||
**These patients first notice difficulty speaking clearly | **These patients first notice difficulty speaking clearly | ||
**Garbled and slurred speech | **Garbled and slurred speech | ||
** Nasality and loss of volume are frequently the first symptoms | **Nasality and loss of volume are frequently the first symptoms | ||
**Difficulty swallowing and loss of tongue mobility follow | **Difficulty swallowing and loss of tongue mobility follow | ||
** Eventually total loss of speech and the inability to [[Pulmonary aspiration|protect the airway]] when swallowing are experienced | **Eventually total loss of speech and the inability to [[Pulmonary aspiration|protect the airway]] when swallowing are experienced | ||
*[[Muscle weakness]] and [[atrophy]] spread to other parts of the body as the disease progresses | *[[Muscle weakness]] and [[atrophy]] spread to other parts of the body as the disease progresses | ||
*Increasing difficulty moving | *Increasing difficulty moving | ||
| Line 33: | Line 32: | ||
**[[Hyperreflexia]] or exaggerated reflexes including overactive gag reflex and positive [[Babinski sign]] | **[[Hyperreflexia]] or exaggerated reflexes including overactive gag reflex and positive [[Babinski sign]] | ||
*Lower Motor Neuron involvement: | *Lower Motor Neuron involvement: | ||
** | **Muscle weakness and atrophy, | ||
** | **Muscle cramps, and | ||
** | **Fleeting twitches of muscles that can be seen under the skin (fasciculations) | ||
*45% of patients experience [[pseudobulbar affect]], also known as "emotional lability" attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion | *45% of patients experience [[pseudobulbar affect]], also known as "emotional lability" attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion | ||
** | **Uncontrollable laughter | ||
** | **Crying or smiling | ||
*[[Frontotemporal dementia]] | *[[Frontotemporal dementia]] | ||
Revision as of 15:52, 24 August 2012
|
Amyotrophic lateral sclerosis Microchapters |
|
Differentiating Amyotrophic lateral sclerosis from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Amyotrophic lateral sclerosis physical examination On the Web |
|
American Roentgen Ray Society Images of Amyotrophic lateral sclerosis physical examination |
|
Amyotrophic lateral sclerosis physical examination in the news |
|
Risk calculators and risk factors for Amyotrophic lateral sclerosis physical examination |
Overview
Physical Examination
Pulmonary
- Nocturnal hypoventilation
- Pneumonia may compromise pulmonary function even further
- Pulmonary failure
- Pulmonary function test:
- Decreased forced vital capacity
- Inspiratory pressure diminishes
Gastrointestinal
Neurologic
- Limb onset:
- Awkwardness when walking or running
- Tripping or stumbling
- Difficulty with simple tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock** Occasionally the symptoms remain confined to one limb; this is known as monomelic amyotrophy.
- Bulbar onset:
- These patients first notice difficulty speaking clearly
- Garbled and slurred speech
- Nasality and loss of volume are frequently the first symptoms
- Difficulty swallowing and loss of tongue mobility follow
- Eventually total loss of speech and the inability to protect the airway when swallowing are experienced
- Muscle weakness and atrophy spread to other parts of the body as the disease progresses
- Increasing difficulty moving
- Swallowing (dysphagia)
- Speaking or forming words (dysarthria)
- Upper motor neuron involvement:
- Spasticity
- Hyperreflexia or exaggerated reflexes including overactive gag reflex and positive Babinski sign
- Lower Motor Neuron involvement:
- Muscle weakness and atrophy,
- Muscle cramps, and
- Fleeting twitches of muscles that can be seen under the skin (fasciculations)
- 45% of patients experience pseudobulbar affect, also known as "emotional lability" attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion
- Uncontrollable laughter
- Crying or smiling
- Frontotemporal dementia