Clinico-Pathological Studies of Long Survival ALS Cases Maintained by Active Life-Support Measures
The final outcome of ALS is fairly uniform regardless of the rapidity of progression; respiratory insufficiency accentuated by aspiration with the risk of choking or pneumonia at stage 4 is the usual cause of death in most of the cases. The classical clinico-pathological correlations of ALS have been based upon these usual cases of stage 4 death[2–3]. Several long-survival case reports[4–5] deal with patients with a protracted clinical course, but the final state of the patients is usually at stage 4, and therefore is not fundamentally different from that of the ordinary cases. On the contrary, what is going to be presented in this report, deals with three sporadic ALS patients (Table 1) who had survived the usual final stage 4 by active life-support measures such as continuous artificial ventilation and tube feeding for years and died at stage 5 which can not usually be attained even in cases with a protracted long-survival course.
KeywordsAmyotrophic Lateral Sclerosis Motor Neuron Motor Nucleus Lower Motor Neuron Sporadic Amyotrophic Lateral Sclerosis
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