Advanced management options for patients with amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with a heterogeneous clinical picture and an unfavorable prognosis. A lot of data has been accumulated on the pathogenesis, risk factors for ALS, and diagnostic criteria for the disease have been formulated, but treatment options for this pathology are limited. Timely diagnosis and initiation of therapy play a key role in improving the course of the disease. The article presents a clinical case of a 69-year-old patient with a sporadic form of ALS, who had been experiencing increasing muscle weakness in her legs, fasciculations, and bulbar disorders (dysarthria, dysphagia) for 9 months. The diagnosis was established in accordance with modern diagnostic criteria based on a combination of clinical signs of damage to the central and peripheral motor neurons and the results of needle electromyography, which confirmed a generalized neurogenic process, and the absence of data for other diseases. The key condition for the diagnosis was the progressive deterioration of motor function, while excluding other causes. The drug riluzole (Teglutik) in the form of an oral suspension was prescribed as pathogenetic therapy. Against the background of four months of therapy, stabilization of the condition was achieved: the indicator on the ALSFRS-R functional scale remained at the same level (35 points at the initial examination, 34 points at the examination after 4 months), there was no progression of symptoms. The absence of negative dynamics on the ALSFRS-R scale in the first months of treatment is considered as a clinically favorable sign. At the moment, riluzole is the only drug in the Russian Federation with proven efficacy that has a reliably confirmed effect on the life expectancy of patients with ALS. The presented case demonstrates the effectiveness of early administration of riluzole (Teglutik) to slow the progression of ALS as part of an integrated approach to patient management.

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