肌萎缩性侧索硬化|肌萎缩性侧索硬化症的奥秘( 二 )
由于缺乏早期疾病的诊断测试,临床医生必须依靠临床症状来识别UMN和LMN征兆的组合 。由于典型的ALS症状可能是许多其他罕见的神经退行性疾病的一部分,因此明确的诊断通常会进一步延迟 。因此,鉴别诊断需要详尽的临床和实验室分析,其中涉及脑成像的测试通常有助于早期诊断 。
由于尚无关于为什么,在哪里以及如何开始这种疾病的完整理解,因此寻找治疗方法仍然具有挑战性 。此外,缺乏适当的早期诊断技术意味着当有效治疗的可能性最高时,会浪费宝贵的时间 。
迄今为止,只有一种药物Riluzole被证明可以改变这种疾病的病程,而且只能有效几个月 。但这并不意味着没有进展 。在其他动物上已经取得了许多有希望的研究,因此有必要将这项研究转化为人类 。
目前,大多数ALS治疗是对症和支持性的 。它们包括物理疗法,矫形器以及疼痛,吞咽困难,呼吸困难,疼痛,便秘,发声以及精神和情绪问题的治疗 。
参考:
Armon, C., 2009. Smoking may be considered an established risk factor for sporadic ALS. Neurology 73, 1693–1698. doi: 10.1212/WNL.0b013e3181c1df48.
Ascherio, A., Weisskopf, M.G., O’Reilly, E.J., Jacobs, E.J., McCullough, M.L., Calle, E.E., Cudkowicz, M., Thun, M.J., 2005. Vitamin E intake and risk of amyotrophic lateral sclerosis. Ann. Neurol. 57, 104–110. doi: 10.1002/ana.20316.
Beard, J.D., Kamel, F., 2015. Military Service, Deployments, and Exposures in Relation to Amyotrophic Lateral Sclerosis Etiology and Survival. Epidemiol. Rev. 37, 55–70. doi: 10.1093/epirev/mxu001.
Das, K., Nag, C., Ghosh, M., 2012. Familial, environmental, and occupational risk factors in development of amyotrophic lateral sclerosis. North Am. J. Med. Sci. 4, 350–355. doi: 10.4103/1947-2714.99517.
Gallo, V., Wark, P.A., Jenab, M., Pearce, N., Brayne, C., Vermeulen, R., Andersen, P.M., Hallmans, G., Kyrozis, A., Vanacore, N., Vahdaninia, M., Grote, V., Kaaks, R., Mattiello, A., Bueno-de-Mesquita, H.B., Peeters, P.H., Travis, R.C., Petersson, J., Hansson, O., Arriola, L., Jimenez-Martin, J.-M., Tj?nneland, A., Halkj?r, J., Agnoli, C., Sacerdote, C., Bonet, C., Trichopoulou, A., Gavrila, D., Overvad, K., Weiderpass, E., Palli, D., Quirós, J.R., Tumino, R., Khaw, K.-T., Wareham, N., Barricante-Gurrea, A., Fedirko, V., Ferrari, P., Clavel-Chapelon, F., Boutron-Ruault, M.-C., Boeing, H., Vigl, M., Middleton, L., Riboli, E., Vineis, P., 2013. Prediagnostic body fat and risk of death from amyotrophic lateral sclerosis: the EPIC cohort. Neurology 80, 829–838. doi: 10.1212/WNL.0b013e3182840689.
Gordon, P.H., 2013. Amyotrophic Lateral Sclerosis: An update for 2013 Clinical Features, Pathophysiology, Management and Therapeutic Trials. Aging Dis. 4, 295–310. doi: 10.14336/AD.2013.0400295.
Gordon, P.H., Cheng, B., Katz, I.B., Pinto, M., Hays, A.P., Mitsumoto, H., Rowland, L.P., 2006. The natural history of primary lateral sclerosis. Neurology 66, 647–653. doi: 10.1212/01.wnl.0000200962.94777.71.
Hardiman, O., Kiernan, M.C., Berg, L.H. van den, 2016. Amyotrophic Lateral Sclerosis, in: Neurodegenerative Disorders. Springer, Cham, pp. 145–165. doi: 10.1007/978-3-319-23309-3_8.
Ingre, C., Roos, P.M., Piehl, F., Kamel, F., Fang, F., 2015. Risk factors for amyotrophic lateral sclerosis. Clin. Epidemiol. 7, 181–193. doi: 10.2147/CLEP.S37505.
Kiernan, M.C., Vucic, S., Cheah, B.C., Turner, M.R., Eisen, A., Hardiman, O., Burrell, J.R., Zoing, M.C., 2011. Amyotrophic lateral sclerosis. The Lancet 377, 942–955. doi: 10.1016/S0140-6736(10)61156-7.
Logroscino, G., Traynor, B.J., Hardiman, O., Chiò, A., Mitchell, D., Swingler, R.J., Millul, A., Benn, E., Beghi, E., Eurals, F., 2010. Incidence of amyotrophic lateral sclerosis in Europe. J. Neurol. Neurosurg. Psychiatry 81, 385–390. doi: 10.1136/jnnp.2009.183525.
Marangi, G., Traynor, B.J., 2015. Genetic causes of amyotrophic lateral sclerosis: New genetic analysis methodologies entailing new opportunities and challenges. Brain Res., The multifaceted nature of ALS. Discoveries and Challenges of the last 5 years 1607, 75–93. doi: 10.1016/j.brainres.2014.10.009.
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