Skip to main content

Amyotrophic Lateral Sclerosis

  • Chapter
  • First Online:
Neuromuscular Disorders in Clinical Practice

Abstract

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease or Charcot’s disease, is a fatal neurodegenerative disorder that primarily affects motor neurons. In this chapter, we outline the epidemiology of ALS followed by a brief overview of the anatomic pathways involved in the disease and a subsequent description of the clinical features. Both the pathology and a diagnostic algorithm are discussed in terms of the currently accepted criteria followed by a discussion on the differential diagnosis. The main theories of pathogenesis are covered to better understand the basis for both the approved and experimental treatment options that are currently available.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 449.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Aran FA. Recherches sur un maladie non encore décrite du système musculaire (atrophie musculaire progressive). Arch Gen Med. 1850;24:15–35.

    Google Scholar 

  2. Duchenne G. Paralysie musculaire progressive de la langue, du voile, du palais et les lèvres. Arch Gen Med. 1860;16(283–296):431–45.

    Google Scholar 

  3. Charcot JM. De la Sclérose latérale amyotrophique. Prog Med. 1874;23:235–7; 24:341–2; 9:453–5

    Google Scholar 

  4. Erb WH. Über einen wenig bekannten spinalen symptomen-­complex. Berl Klin Wochenschr. 1875;12:357–9.

    Google Scholar 

  5. Brain WR. Diseases of the nervous system. London: Oxford University Press; 1933.

    Google Scholar 

  6. Kasarskis EJ, Winslow M. When did Lou Gehrig’s personal illness begin? Neurology. 1989;39:1243–5.

    PubMed  CAS  Google Scholar 

  7. Mulder DW, Kurland LT, Iriarte LLG. Neurologic diseases on the island of Guam. U S Armed Forces Med J. 1954;5:1724–39.

    PubMed  CAS  Google Scholar 

  8. Gadjusek DC. Motor-neuron disease in native of New Guinea. N Engl J Med. 1963;68:474–6.

    Google Scholar 

  9. Gadjusek DC, Salazar AM. Amyotrophic lateral sclerosis and parkinsonian syndromes in high incidence among the Auyu and Jakai people of West New Guinea. Neurology. 1982;32:107–26.

    Google Scholar 

  10. Rosen DR, Siddique T, Patterson D, et al. Mutations in Cu/Zn superoxide dismutase gene are associated with familial amyotrophic lateral sclerosis. Nature. 1993;362:59–62.

    PubMed  CAS  Google Scholar 

  11. Orrell RW, Marklund SL, de Belleroche JS. Familial ALS is associated with mutations in all exons of SOD1: a novel mutation in exon 3 (Gly72Ser). J Neurol Sci. 1997;153:46–9.

    PubMed  CAS  Google Scholar 

  12. World Federation of Neurology Research Group on Neuromuscular Diseases. Classification of neuromuscular disorders. J Neurol Sci. 1994;124:109–30.

    Google Scholar 

  13. McGuire V, Nelson LM. Epidemiology of ALS. In: Mitsumoto H, Przedborski S, Gordon PH, editors. Amyotrophic lateral sclerosis. New York: Taylor and Francis; 2006. p. P17–41.

    Google Scholar 

  14. Matos SE. Mortality rates due to amyotrophic lateral sclerosis in Sao Paolo City from 2002 to 2005. Arq Neuropsiquiatr. 2011;69(6):861–6.

    PubMed  Google Scholar 

  15. Marin B et al. Juvenile and adult onset ALS/MND among Africans: incidence, phenotype, survival: a review. Amyotroph Lateral Scler. 2012;13(3):271–83.

    Google Scholar 

  16. Murray B. Natural history and prognosis in amyotrophic lateral sclerosis. In: Mitsumoto H, Przedborski S, Gordon PH, editors. Amyotrophic lateral sclerosis. New York: Taylor & Francis; 2006. p. 227–55.

    Google Scholar 

  17. Norris F, Shepherd R, Denys E, et al. Onset, natural history and outcome in idiopathic adult motor neuron disease. J Neurol Sci. 1993;118:48–55.

    PubMed  CAS  Google Scholar 

  18. Turner MR, Scaber J, Goodfellow JA, Lord ME, Marsden R, Talbot K. The diagnostic pathway and prognosis in bulbar-onset amyotrophic lateral sclerosis. J Neurol Sci. 2010;294(1–2):81–5.

    PubMed  Google Scholar 

  19. McCombe PA, Henderson RD. Effects of gender in amyotrophic lateral sclerosis. Gend Med. 2010;7(6):557–70.

    PubMed  Google Scholar 

  20. Burrell JR, Vucic S, Kiernan MC. Isolated bulbar phenotype of amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2011;12(4):283–9.

    PubMed  Google Scholar 

  21. Johansen C, Olson JH. Mortality from amyotrophic lateral sclerosis, other chronic disorders and electrical shocks among utility workers. Am J Epidemiol. 1998;148(4):362–8.

    PubMed  CAS  Google Scholar 

  22. Johansen C. Electromagnetic fields and health effects – epidemiologic studies of cancer, diseases of the nervous system and nervous system and arrhythmia-related heart disease. Scand J Work Environ Health. 2004;30 Suppl 1Suppl 1:1–30.

    PubMed  Google Scholar 

  23. Beghi E, Logroscino G, Chiò A, Hardiman O, Millul A, Mitchel D, et al. Amyotrophic lateral sclerosis, physical exercise, trauma and sports: results of a population-based pilot case–control study. Amyotroph Lateral Scler. 2010;11(3):209–92.

    Google Scholar 

  24. Turner MR, Wotton C, Talbot K, Goldcare MJ. Cardiovascular features as a risk factor for amyotrophic lateral sclerosis. Indirect ­evidence from a record linkage study. J Neurol Neurosurg Psychiatry. 2012;83(4):395–6.

    PubMed  Google Scholar 

  25. Mattison P, Lonnstedt I, Nygren I, Askmark H. Physical fitness, but not muscle strength, is a risk factor for death in amyotrophic lateral sclerosis at an early age. J Neurol Neurosurg Psychiatry. 2012;83(4):390–4.

    Google Scholar 

  26. Wang H, O’Reilly EJ, Weisskopf MG, et al. Smoking and risk of amyotrophic lateral sclerosis: a pooled analysis of 5 prospective cohorts. Arch Neurol. 2011;68(2):207–13.

    PubMed  Google Scholar 

  27. Caller TA, Field NC, Chipman JW, Shi X, Harris BT, Stommel EW. Spatial clustering of amyotrophic lateral sclerosis and the potential role of BMAA. Amyotroph Lateral Scler. 2012;13(1):25–32.

    PubMed  CAS  Google Scholar 

  28. Kamel F, Umbach DM, Bedlack RS, et al. Pesticide exposure and amyotrophic lateral sclerosis. Neurotoxicology. 2012;33(3):457–62.

    PubMed  CAS  Google Scholar 

  29. Ghez C. In: Kandel ER, Schwartz JH, Jessell TM, editors. Principals of neural science. 3rd ed. New York: Elsevier; 1991. p. 544.

    Google Scholar 

  30. Hohara N, Kaji R, Kojima Y, Kimura J. An electrophysiological study of the corticospinal projections in amyotrophic lateral sclerosis. Clin Neurophysiol. 1999;110:1123–32.

    Google Scholar 

  31. Holstege G. Descending motor pathways and the spinal motor system. Limbic and non-limbic components. In: Holstege G, editor. Role of the forebrain in sensation and behaviour. Amsterdam: Elsevier; 1991. p. 307–421.

    Google Scholar 

  32. Turner MR, Wicks P, Brownstein CA, Massagli MP, Toronjo M, Talbot K, et al. Concordance between site of onset and limb ­dominance in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry. 2011;82(8):853–4.

    PubMed  CAS  Google Scholar 

  33. Brown P. Pathophysiology of spasticity. J Neurol Neurosurg Psychiatry. 1994;57:773–7.

    PubMed  CAS  Google Scholar 

  34. Okuda B, Kodama N, Kawabata K, Tachibana H, Sugita M. Corneomandibular reflex in ALS. Neurology. 1999;52(8):1699–701.

    PubMed  CAS  Google Scholar 

  35. Rowland LP. Babinski and the diagnosis of amyotrophic lateral sclerosis. Ann Neurol. 1993;33:108–9.

    PubMed  CAS  Google Scholar 

  36. Kuncl RW, Cornblath DR, Griffin JW. Assessment of thoracic paraspinal muscles in the diagnosis of ALS. Muscle Nerve. 1988;11:484–92.

    PubMed  CAS  Google Scholar 

  37. Williams DR. The yawning reflex: an upper motor neuron sign in amyotrophic lateral sclerosis. Neurology. 2000;55(10):1592–3.

    PubMed  CAS  Google Scholar 

  38. Kimura K, Tachibana N, Kimura J, Shibasaki H. Sleep-disordered breathing at an early stage of amyotrophic lateral sclerosis. J Neurol Sci. 1999;164:37–43.

    PubMed  CAS  Google Scholar 

  39. Aboussouan L, Lewis R. Sleep, respiration and ALS. J Neurol Sci. 1999;164:1–2.

    PubMed  CAS  Google Scholar 

  40. Gautier G, Verschueren A, Monnier A, Attarian S, Salort-Campana E, Pouget J. ALS with respiratory onset; clinical features and effects of non-invasive ventilation on the prognosis. Amyotroph Lateral Scler. 2010;11(4):379–82.

    PubMed  Google Scholar 

  41. McElhiney MC, Rabkin JG, Gordon PH, Goetz R, Mitsumoto H. Prevalence of fatigue and depression in ALS patients and change over time. J Neurol Neurosurg Psychiatry. 2009;80(10):1146–9.

    PubMed  CAS  Google Scholar 

  42. Vucic S, Cheah BC, Kiernan MC. Maladaptation of cortical circuits underlies fatigue and weakness in ALS. Amyotroph Lateral Scler. 2011;12(6):414–20.

    PubMed  Google Scholar 

  43. Dupuis L, Pradat P-F, Ludolph AC, Loeffler J-P. Energy metabolism in amyotrophic lateral sclerosis. Lancet Neurol. 2011;10:75–82.

    PubMed  CAS  Google Scholar 

  44. Funalot B, Desport JC, Sturtz F, Camu W, Couratier P. High metabolic levels in patients with familial amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2008;16:1–5.

    Google Scholar 

  45. Gentileschi V, Muggia S, Polani M, Spinnler H. Frontotemporal dementia and motor neuron disease: a neuropsychological study. Acta Neurol Scand. 1999;100:341–9.

    PubMed  CAS  Google Scholar 

  46. Vieregge P, Wausckuhn B, Hebrlin I, et al. Selective attention is impaired in amyotrophic lateral sclerosis- a study of event-related EEG potentials. Brain Res Cogn Brain Res. 1999;8:27–35.

    PubMed  CAS  Google Scholar 

  47. Abe K, Fujimura H, Toyooka K, et al. Cognitive function in ­amyotrophic lateral sclerosis. J Neurol Sci. 1997;148:96–100.

    Google Scholar 

  48. Strong MJ, Grace GM, Orange JB, et al. A prospective study of cognitive impairment in ALS. Neurology. 1999;53(8):1665–70.

    PubMed  CAS  Google Scholar 

  49. Rakowicz WP, Hodges JR. Dementia and aphasia in motor neuron disease: an underrecognised association? J Neurol Neurosurg Psychiatry. 1998;65:881–9.

    PubMed  CAS  Google Scholar 

  50. Rippon GA, Scarmeas N, Gordon PH, Murphy PL, Albert SM, Mitsumoto H, et al. An observational study of cognitive impairment in amyotrophic lateral sclerosis. Arch Neurol. 2006;63(3):345–52.

    PubMed  Google Scholar 

  51. Phukan J, Hardiman O, et al. The syndrome of cognitive impairment in amyotrophic lateral sclerosis: a population-based study. J Neurol Neurosurg Psychiatry. 2012;83:102–8.

    PubMed  Google Scholar 

  52. Lomen-Hoerth C, Murphy J, Langmore S, et al. Are amyotrophic lateral sclerosis patients cognitively normal? Neurology. 2003;60:1094–7.

    PubMed  CAS  Google Scholar 

  53. Mackenzie IR. The neuropathology of FTD associated with ALS. Alzheimer Dis Assoc Disord. 2007;21(4):S44–9.

    PubMed  Google Scholar 

  54. Neumann M, Sampathu DM, Kwong LK, et al. Ubiquitinated TDP-43 in frontotemporal lobar degeneration and amyotrophic lateral sclerosis. Science. 2006;314:130–3.

    PubMed  CAS  Google Scholar 

  55. Renton AE, Majounie E, Waite A, Traynor BJ, et al. A hexanucleotide repeat expansion in C9ORF7-92 is the cause of chromosome 9p21-linked ALS-FTD. Neuron. 2011;72:257–8.

    PubMed  CAS  Google Scholar 

  56. Deng HX, Chen W, Hong ST, Boycott KM, Gorrie GH, Siddique N, et al. Mutations in UBQLN2 cause dominant X-linked juvenile and adult-onset ALS and ALS/dementia. Nature. 2011;477(7363):211–5.

    PubMed  CAS  Google Scholar 

  57. Cooper-Knock J, Hewitt C, Highley JR, et al. Clinico-pathological features in amyotrophic lateral sclerosis with expansions in C9ORF72. Brain. 2012;135:751–64.

    PubMed  Google Scholar 

  58. Blair IP, Williams KL, Warraich ST. FUS mutations in amyotrophic lateral sclerosis: clinical, pathological, neurological and genetic analysis. J Neurol Neurosurg Psychiatry. 2010;81:639–45.

    PubMed  Google Scholar 

  59. Kiernan MC. Amyotrophic lateral sclerosis and frontotemporal dementia. J Neurol Neurosurg Psychiatry. 2012;83:355.

    PubMed  Google Scholar 

  60. Hayashi H, Kato S, Kawadi T, et al. Amyotrophic lateral sclerosis: oculomotor function in patients on respirators. Neurology. 1987;37:1431–2.

    PubMed  CAS  Google Scholar 

  61. Leveille A, Kiernen J, Goodwin A, et al. Eye movements in amyotrophic lateral sclerosis. Arch Neurol. 1982;39:684–6.

    PubMed  CAS  Google Scholar 

  62. Moss HE, McCluskey L, Elman L, Hoskins K, Talman L, Grossman M, et al. Cross-sectional evaluation of clinical neuro-ophthalmic abnormalities in an amyotrophic lateral sclerosis population. J Neurol Sci. 2012;314(1–2):97–101.

    PubMed  Google Scholar 

  63. De Carvalho L, Motta R, Battaglia MA, Brichetto G. Urinary ­disorders in amyotrophic lateral sclerosis subjects. Amyotroph Lateral Scler. 2011;12(5):352–5.

    Google Scholar 

  64. Hamada M, Hanajima R, Terao Y, Sato F, Okano T, Yuasa K, et al. Median nerve somatosensory evoked potentials and their high-­frequency oscillations in amyotrophic lateral sclerosis. Clin Neurophysiol. 2007;118(4):877–86.

    PubMed  Google Scholar 

  65. Ono S, Hu J, Imai T, Shimizu N, Tsumura M, Nakagawa H. Increased expression of insulin-like growth factor I in skin in ­amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry. 2000;69(2):199–203.

    PubMed  CAS  Google Scholar 

  66. Desai J, Swash M. Extrapyramidal involvement in amyotrophic ­lateral sclerosis: backward falls and retropulsion. J Neurol Neurosurg Psychiatry. 1999;67:214–6.

    PubMed  CAS  Google Scholar 

  67. Gordon PH, Cheng B, Katz IB, Pinto M, Hays AP, Mitsumoto H, et al. The natural history of primary lateral sclerosis. Neurology. 2006;66(5):647–53.

    PubMed  CAS  Google Scholar 

  68. Bruyn RPM, Koelman JHTM, Troost D, de Jong JMBV. Motor neuron disease (amyotrophic lateral sclerosis) arising from longstanding primary lateral sclerosis. J Neurol Neurosurg Psychiatry. 1995;58:742–4.

    PubMed  CAS  Google Scholar 

  69. Younger DS, Chou S, Hays AP, et al. Primary lateral sclerosis: a clinical diagnosis reemerges. Arch Neurol. 1988;45:1304–7.

    PubMed  CAS  Google Scholar 

  70. Singer MA, Statland JM, Wolfe GI, Barohn RJ. Primary lateral sclerosis. Muscle Nerve. 2007;35(3):291–302.

    PubMed  CAS  Google Scholar 

  71. Tartaglia MC, Rowe A, Findlater K, Orange JB, Grace G, Strong MJ. Differentiation between primary lateral sclerosis and ­amyotrophic lateral sclerosis: examination of symptoms and signs at disease onset and during follow –up. Arch Neurol. 2007;649(2):232–6.

    Google Scholar 

  72. Geser F, Stein B, Partain M, et al. Motor neuron disease clinically limited to the lower motor neuron is a diffuse TDP-43 proteinopathy. Acta Neuropathol. 2011;121(40):509–17.

    PubMed  Google Scholar 

  73. Kim WK, Liu X, Sandner J, Pasmantier BA, Andrews J, Rowland LP, et al. Study of 962 patients indicates progressive muscular atrophy is a form of ALS. Neurology. 2009;73(20):1686–92.

    PubMed  CAS  Google Scholar 

  74. Mills CK. Unilateral ascending paralysis and unilateral descending paralysis. JAMA. 1906;47:1638–45.

    Google Scholar 

  75. Wijesekera LC, Mathers S, Talman P, Galtrey C, Parkinson MH, Ganesalingam J, et al. Natural history and clinical features of the flail arm and flail leg ALS variants. Neurology. 2009;72(12):1087–94.

    PubMed  CAS  Google Scholar 

  76. Lai SL, Abramzon Y, Schymick JC, et al. FUS mutations in sporadic amyotrophic lateral sclerosis. Neurobiol Aging. 2010;32:550.

    PubMed  Google Scholar 

  77. Nishimura AL, Mitne-Neto M, Silva HCA, et al. A mutation in the vesicle-trafficking protein VAPB causes late-onset spinal muscular atrophy and amyotrophic lateral sclerosis. Am J Hum Genet. 2004;75:822–31.

    PubMed  CAS  Google Scholar 

  78. Kuhnlein P, Sperfeld A-D, Vanmassenove B, et al. Two German kindreds with familial amyotrophic lateral sclerosis due to TARDBP mutations. Arch Neurol. 2008;65:1185–9.

    PubMed  Google Scholar 

  79. Van Deerlin VM, Leverenz JB, Bekris LM. TARDBP mutations in amyotrophic lateral sclerosis with TDP-43 neuropathology; a genetic and histopathological analysis. Lancet Neurol. 2008;7:409–16.

    PubMed  Google Scholar 

  80. Chow CY, Landers JE, Bergren SK, et al. Deleterious variants of FIG4, a phosphoinositide phosphatase, in patients with ALS. Am J Hum Genet. 2009;84:85–8.

    PubMed  CAS  Google Scholar 

  81. Maruyama H, Morino H, Ito H, et al. Mutations of optineurin in amyotrophic lateral sclerosis. Nature. 2010;465:223–7.

    PubMed  CAS  Google Scholar 

  82. Cox LE, Ferraiuolo L, Goodall EF, Heath PR, Higginbottom A, et al. Mutations in CHMP2B in lower motor neuron predominant amyotrophic lateral sclerosis (ALS). PLoS One. 2010;5(3):e9872.

    PubMed  Google Scholar 

  83. Siddique T, Ajroud-Driss S. Familial amyotrophic lateral sclerosis, a historical perspective. Acta Myol. 2011;30(2):117–20.

    PubMed  CAS  Google Scholar 

  84. Andersen PM, Al-Chalabi A. Clinical genetics of amyotrophic ­lateral sclerosis; what do we really know? Nat Rev Neurol. 2011;7(110):603–15.

    PubMed  CAS  Google Scholar 

  85. Silani V et al. The diagnosis of amyotrophic lateral sclerosis in 2010. Arch Ital Biol. 2011;149(1):5–27.

    PubMed  Google Scholar 

  86. Ticozzi N et al. Genetics of familial amyotrophic lateral sclerosis. Arch Ital Biol. 2011;149(1):65–82.

    PubMed  Google Scholar 

  87. Yang Y. The gene encoding alsin, a protein encoding with three guanine-nucleotide exchange factor domains, is mutated in a form of recessive amyotrophic lateral sclerosis. Nat Genet. 2001;29:160–5.

    PubMed  CAS  Google Scholar 

  88. Chen YZ, Rabin BA, Nicholson GA, Auer-Grumback M, Wagner K, De Jonghe P, et al. DNA/RNA helicase gene mutations in a form of juvenile amyotrophic lateral sclerosis (ALS4). Am J Hum Genet. 2004;74(6):1128–35.

    PubMed  CAS  Google Scholar 

  89. Blair IP, Williams KL, Warraich ST, Durnall JC, Thoeng AD, Manavis J, et al. FUS mutations in amyotrophic lateral sclerosis: clinical, pathological, neurological and genetic analysis. J Neurol Neurosurg Psychiatry. 2010;81:639–45.

    PubMed  Google Scholar 

  90. Shiraki H, Yase Y. Amyotrophic lateral sclerosis and parkinsonism dementia in the Kii Peninsula: comparison with the same disorders in Guam and Alzheimer’s disease. In: Vinken PJ, Bruyn GW, Klawans HL, editors. Disease of the motor system. Handbook of neurology 15. Amsterdam: Elsevier; 1991. p. 273–300.

    Google Scholar 

  91. Forman M, Trojanowski JQ, Lee VM. TDP-43; a novel neurodegenerative proteinopathy. Curr Opin Neurobiol. 2007;1795:548–55.

    Google Scholar 

  92. Snyder LR, Marler TE. Rethinking cycad metabolism research. Commun Integr Biol. 2011;4:86–8.

    PubMed  Google Scholar 

  93. Steele JC, McGeer PL. The ALS/PDC syndrome of Guam and the cycad hypothesis. Neurology. 2008;70(21):1984–90.

    PubMed  Google Scholar 

  94. Borenstein AR, Mortimer JA, Schellenberg GD, Galasko D. The ALS/PDC syndrome of Guam and the cycad hypothesis. Neurology. 2009;72(5):473–6.

    PubMed  Google Scholar 

  95. Spencer PS, Palmer VS, Ludolph AC. On the decline and etiology of high incidence motor system disorder in West Papua (southwest New Guinea). Mov Disord. 2005;20:S119–26.

    PubMed  Google Scholar 

  96. Cox PA, Sacks OW. Cycad neurotoxins, consumption of flying foxes, and ALS-PDC disease in Guam. Neurology. 2002;58:956–9.

    PubMed  Google Scholar 

  97. Bradley WG, Mash DC. Beyond Guam: the cyanobacteria/BMAA hypothesis of the cause of ALS and other neurodegenerative diseases. Amyotroph Lateral Scler. 2009;10:7–20.

    PubMed  CAS  Google Scholar 

  98. Kisby GE, Fry RC, Lasarev MR, Bammler TK, Beyer RP, et al. The cycad genotoxin MAM modulates brain cellular pathways involved in neurodegenerative disease and cancer in a DNA damage-linked manner. PLoS One. 2011;6(6):e20911.

    PubMed  CAS  Google Scholar 

  99. Beckman JS, Estevez AG. Superoxide dismutase, oxidative stress, and ALS. In: Mitsumoto H, Przedborski S, Gordon PH, editors. Amyotrophic lateral sclerosis. New York: Taylor & Francis; 2006. p. 339–54.

    Google Scholar 

  100. Mitsumoto H, Santella R, Liu X, Bogdanov M, Zipprich J, Wu H-C, et al. Oxidative stress biomarkers in sporadic ALS. Amyotroph Lateral Scler. 2008;9:177–83.

    PubMed  CAS  Google Scholar 

  101. Heath PR, Shaw PJ. Amyotrophic lateral sclerosis. In: Mitsumoto H, Przedborski S, Gordon PH, editors. Amyotrophic lateral sclerosis. New York: Taylor & Francis; 2006. p. 299–338.

    Google Scholar 

  102. Rothstein JD. Excitotoxicity hypothesis. Neurology. 1996;47 Suppl 2Suppl 2:S19–26.

    PubMed  CAS  Google Scholar 

  103. Ferraiuolo L, Kirby J, Grierson AJ, Sendtner M, Pamela J, Shaw PJ. Molecular pathways of motor neuron injury in amyotrophic lateral sclerosis. Nat Rev Neurol. 2011;7:616–30.

    PubMed  CAS  Google Scholar 

  104. Mitchell J, Praveen P, Chen H-I, et al. Familial amyotrophic lateral sclerosis is associated with a mutation in D-amino oxidase. Proc Natl Acad Sci. 2010;107:7556–61.

    PubMed  CAS  Google Scholar 

  105. Schulz JB, Matthews RT, Klockgether T, Dichgans J, Beal MF. The role of mitochondrial dysfunction and neuronal nitric oxide in animal models of neurodegenerative diseases. Mol Cell Biochem. 1997;174(1–2):193–7.

    PubMed  CAS  Google Scholar 

  106. Cassarino DS, Bennett Jr JP. An evaluation of the role of mitochondria in neurodegenerative diseases: mitochondrial mutations and oxidative pathology, protective nuclear responses and cell death in neurodegeneration. Brain Res Brain Res Rev. 1999;29(1):1–25.

    PubMed  CAS  Google Scholar 

  107. Shi P, Wei Y, Zhang J, et al. Mitochondrial dysfunction is a converging point of multiple pathological pathways in amyotrophic lateral sclerosis. J Alzheimers Dis. 2010;20:S311–24.

    PubMed  Google Scholar 

  108. Hirano M, Angelini C, Montagna P, Hays AP, Tanji K, Mitsumoto H, et al. Amyotrophic lateral sclerosis with ragged-red fibres. Arch Neurol. 2008;65(3):403–6.

    PubMed  Google Scholar 

  109. Crugnola V, Lamperti C, Lucchini V, et al. Mitochondrial respiratory chain dysfunction in muscle from patients with amyotrophic lateral sclerosis. Arch Neurol. 2010;67(7):849–54.

    PubMed  Google Scholar 

  110. McCluskey LF, Elman LB, Martinez-Lage M, et al. Amyotrophic lateral sclerosis–plus syndrome with TAR DNA-binding protein-43 pathology. Arch Neurol. 2009;66(1):121–4.

    PubMed  Google Scholar 

  111. Johnson JO, Mandrioli J, Benatar M, et al. Exome sequencing reveals VCP mutations as a cause of familial ALS. Neuron. 2010;68(5):857–64.

    PubMed  CAS  Google Scholar 

  112. Philips T, Robberecht W. Neuroinflammation in amyotrophic lateral; sclerosis: role of glial activation in motor neuron disease. Lancet Neurol. 2010;10(3):253–63.

    Google Scholar 

  113. Greenway MJ, Andersen PM, Russ C, et al. ANG mutations ­segregate with familial and ‘sporadic’ amyotrophic lateral ­sclerosis. Nat Genet. 2006;38:411–3.

    PubMed  CAS  Google Scholar 

  114. Leigh PN, Whitwell H, Garofalo O, Buller J, Swash M, Martin JE, et al. Ubiquitin-immunoreactive intraneuronal inclusions in ­amyotrophic lateral sclerosis. Brain. 1991;114(Pt 2):775–88.

    PubMed  Google Scholar 

  115. Mackenzie TR, Rademakers R, Neumann M. TDP-43 and FUS in amyotrophic lateral sclerosis and frontotemporal dementia. Lancet Neurol. 2010;9:995–1007.

    PubMed  CAS  Google Scholar 

  116. Simón-Sánchez J, Dopper EG, Cohn-Hokke PE, et al. The clinical and pathological phenotype of C9orf72 hexanucleotide repeat expansions. Brain. 2012;135(3):723–35.

    PubMed  Google Scholar 

  117. Rowland LP. HIV-related neuromuscular diseases: nemaline ­myopathy, amyotrophic lateral sclerosis, and bibrachial amyotrophic diplegia. Acta Myol. 2011;30(1):29–31.

    PubMed  CAS  Google Scholar 

  118. El-Escorial Revisited: Revised Criteria for the diagnosis of amyotrophic lateral sclerosis. A consensus conference at Airlie House. World Federation of Neurology, Research Group on Motor Neuron Disease (visit the world wide web at: www.wfnals.org/Articles/elescorial1998.htm)

  119. Wilbourn AJ. Clinical neurophysiology in the diagnosis of ­amyotrophic lateral sclerosis: the Lambert and the El Escorial criteria. J Neurol Sci. 1998;160(suppl):S25–9.

    PubMed  Google Scholar 

  120. Wilbourn AJ. Generalized low motor-normal sensory conduction responses: the etiology in 55 patients [abstract]. Muscle Nerve. 1984;7:564.

    Google Scholar 

  121. Eisen A, Kuwabara S. The split hand syndrome in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry. 2012;83(4):399–403.

    PubMed  Google Scholar 

  122. Noto Y, Misawa S, Kanai K, Shibuya K, Isose S, Nasu S, et al. Awaji ALS criteria increase the diagnostic sensitivity in patients with bulbar onset. Clin Neurophysiol. 2012;123(2):382–5.

    PubMed  Google Scholar 

  123. Chen A, Weimer L, Brannagan 3rd T, Colin M, Andrews J, Mitsumoto H, et al. Experience with the Awaji Island modifications to the ALS diagnostic criteria. Muscle Nerve. 2010;42(5):831–2.

    PubMed  Google Scholar 

  124. Carvalho MD, Swash M. Awaji diagnostic algorithm increases sensitivity of El Escorial criteria for ALS diagnosis. Amyotroph Lateral Scler. 2009;10:53–7.

    PubMed  Google Scholar 

  125. Misawa S, Noto Y, Shinuya K, Isose S, Sekiguchi Y, Nasu S, et al. Ultrasonographic detection of fasciculations markedly increases diagnostic sensitivity of ALS. Neurology. 2011;77(16):1532–7.

    PubMed  CAS  Google Scholar 

  126. Shefner JM, Watson ML, Simionescu L, Caress JB, Burns TM, Maragakis NJ, et al. Multipoint incremental motor unit number estimation as an outcome measure in ALS. Neurology. 2011;77(3):235–41.

    PubMed  CAS  Google Scholar 

  127. Swash M, de Carvalho M. The Neurophysiology Index in ALS. Amyotroph Lateral Scler Other Motor Neuron Disord . 2004; suppl 1:108–110

  128. Stälberg E, Schwartz MS, Trontelj JV. Single-fibre electromyography in various processes affecting the anterior horn cell. J Neurol Sci. 1975;24:402–15.

    Google Scholar 

  129. Floyd AG, Yu QP, Piboolnurak P, Tang MX, Fang Y, Smith WA, et al. Transcranial magnetic stimulation in ALS: utility of central motor conduction tests. Neurology. 2009;72(6):498–504.

    PubMed  CAS  Google Scholar 

  130. Verstraete E, Veldink JH, Hendrikse J, Schelhaas HJ, van den Heuvel MP, van den Berg LH. Structural MRI reveals cortical thinning in amyotrophic lateral sclerosis ALS and FTD special edition: research paper. J Neurol Neurosurg Psychiatry. 2012;83(4):383–8.

    PubMed  Google Scholar 

  131. Stanton BR, Shinhmar D, Turner MR, Williams VC, Williams SC, Blain CR, et al. Diffusion tensor imaging in sporadic and familial (D90A SOD1) forms of amyotrophic lateral sclerosis. Arch Neurol. 2009;66(1):109–15.

    PubMed  Google Scholar 

  132. Iwata NK, Kwan JY, Danielian LE, Butman JA, Tovar-Moll F, Bayat E, et al. White matter alterations differ in primary lateral sclerosis and amyotrophic lateral sclerosis. Brain. 2011;134(Pt 9):2642–55.

    PubMed  Google Scholar 

  133. Blain CRV, Brunton S, Williams VC, Leemans A, Turner MR, Andersen PM, et al. Differential corticospinal tract degeneration in homozygous ‘D90A’ SOD-1 ALS and sporadic ALS. J Neurol Neurosurg Psychiatry. 2011;82:843–9.

    PubMed  CAS  Google Scholar 

  134. Renard D, Collombier L, Castelnovo G, Fourcade G, Kotzki PO, LaBauge P. Brain FDG-PET changes in ALS and ALS-FTD. Acta Neurol Belg. 2011;111(4):306–9.

    PubMed  Google Scholar 

  135. Agosta F, Chiò A, Cosottini M, et al. The present and the future of neuroimaging in amyotrophic lateral sclerosis. AJNR Am J Neuroradiol. 2010;31:1769–77.

    PubMed  CAS  Google Scholar 

  136. Turner RT, Kiernan MC, Leigh PN, et al. Biomarkers in amyotrophic lateral sclerosis. Lancet Neurol. 2009;8:94–109.

    PubMed  CAS  Google Scholar 

  137. DeAngelis LM, Posner JB. Neurologic complications of cancer. Oxford, New York: Oxford University Press; 2009. p. 596.

    Google Scholar 

  138. Murphy SM, Khan U, Alifrangis C, Hazell S, Hrouda D, Blake J, et al. Anti Ma2-associated myeloradiculopathy: expanding the phenotype of anti –Ma2 associated paraneoplastic syndromes. J Neurol Neurosurg Psychiatry. 2012;83(2):232–3.

    PubMed  Google Scholar 

  139. Belsh JM, Schiffman PL. The amyotrophic lateral sclerosis (ALS) patient perspective on misdiagnosis and its repercussions. J Neurol Sci. 1996;139(suppl):110–6.

    PubMed  Google Scholar 

  140. Klein CJ, Boes CJ, Chapin JE. Adult polyglucosan body disease: case description of an expanding genetic and clinical syndrome. Muscle Nerve. 2004;29(2):323–8.

    PubMed  CAS  Google Scholar 

  141. Raben N, Danon M, Lu N, et al. Surprises of genetic engineering. A possible model of polyglucosan body disease. Neurology. 2001;56:1739–45.

    PubMed  CAS  Google Scholar 

  142. Moser HW, Smith KD, Watkins PA, Powers J, Moser AB. X-linked adrenoleukodystrophy. The metabolic and molecular basis of inherited disease. 8th ed. New York: McGraw Hill; 2005. p. 3257–301.

    Google Scholar 

  143. Kimber J, McLean BN, Prevett M. Allgrove or 4 A syndrome: an autosomal recessive syndrome causing multisystem neurological disease. J Neurol Neurosurg Psychiatry. 2003;74(5):654–7.

    PubMed  CAS  Google Scholar 

  144. Fink JK. Hereditary spastic paraplegia. Curr Neurol Neurosci Rep. 2006;6(1):65–72.

    PubMed  CAS  Google Scholar 

  145. Saito M, Bangham CRM. Immunopathogenesis of human T-cell leukemia virus Type-1-associated myelopathy/tropical spastic paraparesis: recent perspectives. Leukemia Research and Treatment 2012; article ID 259045, 12 pages

    Google Scholar 

  146. Parodi S, Pennuto M. Neurotoxic effects of androgens in spinal and bulbar muscular atrophy. Front Neuroendocrinol. 2011;32(4):416–25.

    PubMed  CAS  Google Scholar 

  147. Finsterer J. Polyglutamine-expanded mutant AR accumulates in nuclei, undergoes fragmentation, and initiates degeneration and loss of motor neurons. Perspectives of Kennedy’s disease. J Neurol Sci. 2010;298(1–2):1–10.

    PubMed  CAS  Google Scholar 

  148. Trojan DA, Cashman NR. Post-poliomyelitis syndrome. Muscle Nerve. 2005;31(1):6–19.

    PubMed  Google Scholar 

  149. Debiasi RL, Tyler KL. West Nile virus meningoencephalitis. Nat Clin Pract Neurol. 2006;2:264–75.

    PubMed  Google Scholar 

  150. Baek WS, Desai NP. ALS: pitfalls in the diagnosis. Pract Neurol. 2007;7:74–81.

    PubMed  Google Scholar 

  151. Park NJ, Morgan C, Sharma R, Li Y, Lobo RM, Redman JB, et al. Improving accuracy of Tay Sachs carrier screening of the non-Jewish population: analysis of 34 carriers and six late-onset patients with HEXA enzyme and DNA sequence analysis. Pediatr Res. 2010;67(2):217–20.

    PubMed  Google Scholar 

  152. Rowin J, Meriggioli MN, Cochran EJ. Monomelic amyotrophy with late progression. Neuromuscul Disord. 2001;11:305–8.

    PubMed  CAS  Google Scholar 

  153. Waragai M, Chiba A, Uchibori T, Fukushima T, Anno M, Tanaka K. Anti-ma2 associated paraneoplastic neurological syndrome presenting as encephalitis and progressive muscular atrophy. J Neurol Neurosurg Psychiatry. 2006;77:111–3.

    PubMed  CAS  Google Scholar 

  154. Vigliani MC, Polo P, Chio A, Giometto B, Mazzini L, Schiffer D. Patients with amyotrophic lateral sclerosis and cancer do not ­differ clinically from patients with sporadic amyotrophic lateral ­sclerosis. J Neurol. 2000;247(10):778–82.

    PubMed  CAS  Google Scholar 

  155. Rojas-Marcos I, Rousseau A, Keime-Guibert F, Ramon R, Cartalat-Carel S, Delattre J, et al. Spectrum of paraneoplastic neurologic disorders in women with breast and gynecologic cancer. Medicine. 2003;82(3):216–23.

    PubMed  Google Scholar 

  156. Turk HM, Ozet A, Kuzhan O, Komurcu F, Arpaci F, Ozturk B, et al. Paraneoplastic motor neuron disease resembling amyotrophic lateral sclerosis in a patient with renal cell carcinoma. Med Princ Pract. 2009;18(1):73–5.

    PubMed  Google Scholar 

  157. Nobile-Orazio E, Cappellari A, Priori A. Multifocal motor ­neuropathy: current concepts and controversies. Muscle Nerve. 2005;31(6):663–793.

    PubMed  Google Scholar 

  158. Johnson NE, Patraglia AL, Huang JH, Logigian EL. Rapid ­resolution of severe neuralgic amyotrophy after treatment with corticosteroids and intravenous immunoglobulin. Muscle Nerve. 2011;44(2):304–5.

    PubMed  Google Scholar 

  159. van Alfen N, van Engelen BG. The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain. 2006;129:438–50.

    PubMed  Google Scholar 

  160. Titulaer MJ, Lang B, Verschuuren JJ. Lambert Eaton myasthenic syndrome; from clinical characteristics to therapeutic strategies. Lancet Neurol. 2011;10(12):1098–107.

    PubMed  Google Scholar 

  161. Dabby R, Lange DJ, Trojaborg W, Hays AP, Lovelace RE, Brannagan TH, et al. Inclusion body myositis mimicking motor neuron disease. Arch Neurol. 2001;58:1253–6.

    PubMed  CAS  Google Scholar 

  162. Moulignier A, Moulonguet A, Pialoux G. Reversible ALS-like disorder in HIV infection. Neurology. 2001;57(6):995–1001.

    PubMed  CAS  Google Scholar 

  163. MacGowan DJL, Scelsa SN, Waldron M. An ALS-like syndrome with new HIV infection and complete response to antiretroviral therapy. Neurology. 2001;57:1094–7.

    PubMed  CAS  Google Scholar 

  164. Gordon PH, Cheng B, Salachas F, Pradat PF, Bruneteau G, Corcia P, et al. Progression in ALS is not linear but is curvilinear. J Neurol. 2010;257(10):1713–7.

    PubMed  Google Scholar 

  165. Brooks BR, Lewis D, Rawling J, et al. The natural history of amyotrophic lateral sclerosis. In: Williams AC, editor. Motor neuron disease. London: Chapman & Hall Medical; 1994. p. 131–69.

    Google Scholar 

  166. Pringle CE, Hudson AJ, Munoz DG, Kiernan IA, Brown WF, Ebers GC. Primary lateral sclerosis. Clinical features, neuropathology, and diagnostic criteria. Brain. 1992;115:495–520.

    PubMed  Google Scholar 

  167. Floeter MK, Mills R. Progression in primary lateral sclerosis: a prospective analysis. Amyotroph Lateral Scler. 2009;10(5–6):339–46.

    PubMed  Google Scholar 

  168. ALS CNTF Treatment Study (ACTS) Group. Prognostic indicators of survival in amyotrophic lateral sclerosis [abstract] Neurology 1996;46:A208

    Google Scholar 

  169. Desport JC, Preux PM, Truong TC, et al. Nutritional status is a prognostic factor for survival in ALS patients. Neurology. 1999;53:1059–64.

    PubMed  CAS  Google Scholar 

  170. Miller RG, Jackson CE, Kasarsksi EJ, et al. Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2009;73(15):1227–33.

    PubMed  CAS  Google Scholar 

  171. Miller RG, Jackson CE, Kasarsksi EJ, et al. Practice parameter update; the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2009;73(15):1218–26.

    PubMed  CAS  Google Scholar 

  172. Riluzole for amyotrophic lateral sclerosis (ASL)/motor neuron disease (MND). Cochrane Database Syst Rev. 2012;3:CD001447.

    Google Scholar 

  173. Miller RG, Mitchell JD, Lyon M, Moore DH. Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) Cochrane Database Syst Rev. 2007:CD001447

    Google Scholar 

  174. Cudkowicz M, Bozik ME, Ingersoll EW, Miller R, Mitsumoto H, Shefner J, et al. The effects of dexpramipexole (KNS-760704) in individuals with amyotrophic lateral sclerosis. Nat Med. 2011;17:1652–6.

    PubMed  CAS  Google Scholar 

  175. Gilio F, Iacovelli E, Frasca V, Gabriele M, Giacomelli E, Picchiori F, et al. Botulinum toxin type A for the treatment of sialorrhoea in amyotrophic lateral sclerosis: a clinical and neurophysiological study. Amyotroph Lateral Scler. 2010;11(4):359–63.

    PubMed  CAS  Google Scholar 

  176. Kasarskis EJ, Hodskins J, St Clair WH. Unilateral parotid electron beam radiotherapy as palliative treatment for sialorrhea in amyotrophic lateral sclerosis. J Neurol Sci. 2011;308(1):155–7.

    PubMed  Google Scholar 

  177. Leigh PN, Abrahams S, Al-Chalabi A, Ampong MA, Goldstein LH, Johnson J, et al. The management of motor neurone disease. J Neurol Neurosurg Psychiatry. 2003;74 Suppl 4Suppl 4:32–47.

    Google Scholar 

  178. Chio A, Galletti R, Finocchiaro C, Righi D, Ruffino MA, Calvo A, et al. Percutaneous radiological gastrostomy: a safe and effective method of nutritional tube placement in advanced ALS. J Neurol Neurosurg Psychiatry. 2004;75:645–7.

    PubMed  CAS  Google Scholar 

  179. Andersen PM, Borasio GD, Dengler R, Hardiman O, Kollewe K, Leigh PN, et al. EFNS task force on management of amyotrophic lateral sclerosis: guidelines for diagnosing and clinical care of patients and relatives. Eur J Neurol. 2005;12:921–38.

    PubMed  CAS  Google Scholar 

  180. Lyall RA, Donaldson N, Polkey MI, Leigh PN, Moxham J. Respiratory muscle strength and ventilatory failure in amyotrophic lateral sclerosis. Brain. 2001;124:2000–13.

    PubMed  CAS  Google Scholar 

  181. Lechtzin N, Wiener CM, Shade DM, Clawson L, Diette GB. Spirometry in the supine position improves the detection of ­diaphragmatic weakness in patients with amyotrophic lateral ­sclerosis. Chest. 2002;121:436–44.

    PubMed  Google Scholar 

  182. Gruis KL, Brown DL, Schoennemann A, Zebarah VA, Feldman EL. Predictors of noninvasive ventilation tolerance in patients with ­amyotrophic lateral sclerosis. Muscle Nerve. 2005;32:808–11.

    PubMed  CAS  Google Scholar 

  183. Schmidt EP, Drachman DB, Wiener CM, Clawson L, Kimball R, Lechtzin N. Pulmonary predictors of survival in amyotrophic ­lateral sclerosis: use in clinical trial design. Muscle Nerve. 2006;33:127–32.

    PubMed  Google Scholar 

  184. Bourke SC, Tomlinson M, Williams TL, Bullock RE, Shaw PJ, Gibson GJ. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial. Lancet Neurol. 2006;5:140–7.

    PubMed  Google Scholar 

  185. Adriano Chiò, Andrea Calvo, Cristina Moglia, Federica Gamna, Alessio Mattei, Letizia Mazzini, Gabriele Mora, and the PARALS.ALS and FTD Special Edition: Research paper: Non-invasive ventilation in amyotrophic lateral sclerosis: a 10 year population based study J Neurol Neurosurg Psychiatry 2012;83(4):377–81

    Google Scholar 

  186. Mitsumoto H, Rabkin JG. Palliative care for patients with amyotrophic lateral sclerosis ‘prepare for the worst and hope for the Best’. JAMA. 2007;298(2):207–16.

    PubMed  CAS  Google Scholar 

  187. Mitsumoto H. Amyotrophic lateral sclerosis. Patient and family guide to management and care. 3rd ed. New York: Demos; 2009.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hiroshi Mistumoto MD, DSc .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Lonergan, R., Mistumoto, H., Murray, B. (2014). Amyotrophic Lateral Sclerosis. In: Katirji, B., Kaminski, H., Ruff, R. (eds) Neuromuscular Disorders in Clinical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6567-6_20

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-6567-6_20

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6566-9

  • Online ISBN: 978-1-4614-6567-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics