AI Article Synopsis

  • The author shares a 40-year journey as a clinical neurologist specializing in treating amyotrophic lateral sclerosis (ALS), highlighting five patient cases from their early career at Chiba University Hospital.
  • A notable case involves a patient who battled ALS for 31 years, ultimately facing total locked-in syndrome, illustrating the long-term challenges of the disease.
  • The author also examines the profiles and treatment responses of 24 patients, discussing diagnostic delays and the complexities of caregiving and medical management for ALS patients.

Article Abstract

This narrative summary presents the author's 40-year experience as a clinical neurologist who treated patients with amyotrophic lateral sclerosis (ALS). Five representative cases from the author's first 20 years at Chiba University Hospital and its affiliated hospitals were selected, including a patient of respiratory-onset who was ignorantly extubated by a female relative for patient's distress to the intratracheal tube. Based on the latter 20 years of experience at the author's current hospital, the author first describes a famous patient with ALS who was being treated at this medical center before the author was assigned to this hospital and fought against ALS for 31 years before eventually succumbing to total locked-in syndrome. Thereafter, the author has summarized the ages, sex, phenotypes, comorbidities, responses to the available treatment options, and total number of years that have elapsed for the 24 patients that the author initially examined in the outpatient clinic. In terms of diagnostic delay, the author describes "foot drop" in patients who developed lower limb symptoms, and hoarseness in those who developed bulbar palsy. Furthermore, the author discusses issues regarding family caregiving capacity, patient's and families' understanding of notification, and medical management (i.e., medications, rehabilitation for ADL, nutrition and respiration, complications of frontotemporal dementia, and medical cooperation with other clinics and hospitals).

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Source
http://dx.doi.org/10.11477/mf.1416202762DOI Listing

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