PMID: 9163756May 1, 1997Paper

Clinical classification of ALS patients based on the total course of ALS--proposal of respiratory motor paralysis-preceded type and its significance

Nō to shinkei = Brain and nerve
H HayashiA Kawada

Abstract

Since the motor paralysis occurs in all motor systems in ALS, the clinicopathological findings and care of the patients living beyond the development of respiratory failure must be considered. We have divided the efferent motor systems into four groups, i.e., limb, bulbar, respiratory, and external ocular. In this study, 37 ALS patients were followed for more than two years with respirator, and the onset of motor paralysis in all four systems was observed in each patient. First, we classified the patients into three groups according to the number of paralyzed motor systems observed within six months from the onset of the first motor paralysis, and we discuss the patient's prognosis after the first motor paralysis. Twenty-one patients with paralysis of the respiratory motor system alone were categorized as respiratory paralysis-preceded type ALS (R-type ALS), four patients with paralysis of the bulbar motor system alone as bulbar paralysis-preceded type ALS (B-type ALS), and 12 patients with simultaneous paralysis of two or more motor systems as combined motor system paralysis type ALS (C-type ALS). The results showed that the prognosis of R-type ALS is slow progression and that of C-type ALS, rapid progression. Next, we investi...Continue Reading

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