Clinical Statistics in 515 Fatal Cases of Motor Neuron Disease

Kondo, Kiyotaro; Hemmi, Isao

doi:10.1159/000110849

Cited by 24 publications

(13 citation statements)

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“…Two large retrospective epidemiological studies have reported the presence of unspecified dementia in 4% and 6% of patients with MND,32 33 whereas two smaller prospective studies did not identify any demented patients 1214 Likewise, a large recent study of 146 patients under follow up by a specialist MND outpatient service seemed not to report any frankly demented patients despite finding evidence of more subtle cognitive impairment on neuropsychological assessment in a third of cases 17…”

Section: Discussionmentioning

confidence: 99%

Dementia and aphasia in motor neuron disease: an underrecognised association?

Rakowicz

Hodges

1998

Journal of Neurology, Neurosurgery & Psychiatry

110

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Objectives-To determine the prevalence and nature of global cognitive dysfunction and language deficits in an unselected population based cohort of patients with motor neuron disease (MND). Methods--A battery of neuropsychological and language tests was administered to patients presenting consecutively over a 3 year period to a regional neurology service with a new diagnosis of sporadic motor neuron disease. Results-The 18 patients could be divided on the basis of their performance into three groups: Three patients were demented and had impaired language function (group 1); two non-demented patients had an aphasic syndrome characterised by word finding diYculties and anomia (group 2). Major cognitive deficits were therefore found in five of the 18 patients (28%). The remaining 13 performed normally on the test battery apart from decreased verbal fluency (group 3). Conclusions-The prevalence of cognitive impairment in MND in this population based study of an unselected cohort was higher than has been previously reported. Language deficits, especially anomia, may be relatively frequent in the MND population. Aphasia in MND may be masked by dysarthria and missed if not specifically examined. (J Neurol Neurosurg Psychiatry 1998;65:881-889)

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Section: Discussionmentioning

confidence: 99%

Dementia and aphasia in motor neuron disease: an underrecognised association?

Rakowicz

Hodges

1998

Journal of Neurology, Neurosurgery & Psychiatry

110

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“…Bulbar progressive paresis (bulbar onset) occurs in 25%–35% of patients, whereas 70%–81% of all forms will develop bulbar symptoms of dysarthria and dysphagia 9 , 26 , 28 , 29 . Symptoms of bulbar involvement begin with salivary pooling and dysarthria 30 .…”

Section: Risk Factors For Malnutrition In Amyotrophic Lateral Sclerosmentioning

confidence: 99%

Nutrition Management of Amyotrophic Lateral Sclerosis

Greenwood

2013

Nut in Clin Prac

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Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease with high risk of malnutrition. Symptoms of dysphagia, depression, cognitive impairment, difficulty with self-feeding and meal preparation, hypermetabolism, anxiety, respiratory insufficiency, and fatigue with meals increase the risk of malnutrition. Malnutrition negatively affects prognosis and quality of life, making early and frequent nutrition assessment and intervention essential. Implementation of an adequate calorie diet, dietary texture modification, use of adaptive eating utensils, and placement of a feeding tube aid in preventing malnutrition. When nutrition status is compromised by dysphagia and weight loss (5%-10% of usual body weight) or body mass index <20 kg/m(2) without weight loss and when forced vital capacity is >50%, a percutaneous endoscopic gastrostomy placement is indicated. When forced vital capacity is <50%, a radiologically inserted gastrostomy is the preferred means of enteral placement due to lessened aspiration and respiratory risk. Parenteral nutrition (PN) is indicated only when enteral nutrition (EN) is contraindicated or impossible. This article reviews the background of ALS, nutrition implications and risk of malnutrition, treatment strategies to prevent malnutrition, the role of EN and PN, and feeding tube placement methods according to disease stage.

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“…In Amyotrophic Lateral Sclerosis/Motor Neurone Disease (ALS/MND) 50-70 % of patients ultimately experience bulbar symptoms such as dysphagia [4,11] so alternative methods of nutritional support are sought. In recent years, percutaneous endoscopic gastrostomy (PEG) feeding tubes have been proposed as an alternative to nasogastric tubes as a means of circumventing neurogenic dysphagia [15].…”

Section: Introductionmentioning

confidence: 99%

Frequency, timing and outcome of gastrostomy tubes for amyotrophic lateral sclerosis/motor neurone disease

2004

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We found that gastrostomy feeding tubes are being inserted more frequently in people with ALS/MND. An unexpectedly high early mortality was detected which probably reflects a lack of selection bias compared with previously published data. It is possible that changes in the practice of gastrostomy placement since 1998 result in better outcomes for patients with ALS/MND. Prospective studies are required to assess the risks and benefits of enteral nutrition in ALS/MND.

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Clinical Statistics in 515 Fatal Cases of Motor Neuron Disease

Cited by 24 publications

References 0 publications

Dementia and aphasia in motor neuron disease: an underrecognised association?

Dementia and aphasia in motor neuron disease: an underrecognised association?

Nutrition Management of Amyotrophic Lateral Sclerosis

Frequency, timing and outcome of gastrostomy tubes for amyotrophic lateral sclerosis/motor neurone disease

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