The quality of care and symptom control — the effects on the terminal phase of ALS/MND
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Cited by (90)
Pain in amyotrophic lateral sclerosis
2017, The Lancet NeurologyCitation Excerpt :In one study,55 during the last month of life, 52% of patients with ALS reported pain as present almost all the time or as constant, and rated it as moderate or severe. A study of patients with ALS admitted to a hospice reported that pain was present in more than 75% of patients and that most had uncontrolled pain before the admission.56 The presence of pain, as assessed with the Bodily Pain domain of the Short Form (36) Health Survey, did not influence the decision of patients with ALS to accept or decline non-invasive ventilation.57
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2013, Respiratory Physiology and NeurobiologyCitation Excerpt :Although there is patient variability in spinal-onset ALS patients, muscle weakness in accessory respiratory muscles such as the intercostal and abdominal muscles occur later than muscle weakness in the extremities, but before the muscles of swallowing and speech (Marti-Fabregas et al., 1995; Lechtzin, 2006). During spinal onset ALS, the muscles maintaining upper airway tone are relatively spared in ALS, but will eventually weaken in late-stage disease (Oliver, 1996). Bulbar onset ALS patients often present with symptoms of dysarthria, dysphagia, and tongue fasciculation, indicating early onset of upper airway muscle weakness (Kuhnlein et al., 2008).
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