Respiratory failure as the presenting manifestation of amyotrophic lateral sclerosis

Narat Srivali; Jay H Ryu; Jeffrey T Rabatin

doi:10.1016/j.jocn.2015.12.018

Respiratory failure as the presenting manifestation of amyotrophic lateral sclerosis

J Clin Neurosci. 2016 Jul:29:201-2. doi: 10.1016/j.jocn.2015.12.018. Epub 2016 Feb 15.

Authors

Narat Srivali¹, Jay H Ryu², Jeffrey T Rabatin²

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Gonda 18 South, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. Electronic address: [email protected].
² Division of Pulmonary and Critical Care Medicine, Gonda 18 South, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.

PMID: 26899358
DOI: 10.1016/j.jocn.2015.12.018

Abstract

Although amyotrophic lateral sclerosis (ALS) does not directly affect the lung parenchyma, it can jeopardize the mechanical function of the respiratory system. About one-quarter of ALS patients have had at least one prior misdiagnosis. Therefore, a high clinical suspicion, and careful correlation of physical examination and electromyography (EMG) are needed to reach the correct diagnosis. We report a 65-year-old man who presented with a progressive exertional dyspnea. He was subsequently found to have a diaphragmatic paralysis that was felt to be secondary to spinal cord stenosis. However, his subsequent EMG showed evidence of muscle fasciculation and he was ultimately diagnosed with ALS.

Keywords: Amyotrophic lateral sclerosis; Diaphragmatic paralysis; Respiratory failure.

Publication types

Case Reports

MeSH terms

Aged
Amyotrophic Lateral Sclerosis / complications*
Amyotrophic Lateral Sclerosis / diagnosis*
Electromyography
Fasciculation / etiology
Humans
Male
Respiratory Paralysis / etiology*