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Semin Neurol 2023; 43(05): 776-790
DOI: 10.1055/s-0043-1775595
Review Article

Neuroprognostication for Patients with Amyotrophic Lateral Sclerosis: An Updated, Evidence-Based Review

Christina Martin Schaff
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Jerome E. Kurent
2   Department of Neurology and Medicine, Medical University of South Carolina, Charleston, South Carolina
3   Department of Neurology, ALS Multidisciplinary Clinic, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
,
Sherry Kolodziejczak
4   ALS Clinic Treatment Center of Excellence, Crestwood Medical Center, Huntsville, Alabama
,
Michelle Milic
5   Division of Pulmonary, Critical Care, and Sleep Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia
6   Division of Palliative Care Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia
,
Laura A. Foster
7   Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado
,
Ambereen K. Mehta
1   Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
8   Palliative Care Program, Division of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder that presents and progresses in various ways, making prognostication difficult. Several paradigms exist for providers to elucidate prognosis in a way that addresses not only the amount of time a patient has to live, but also a patient's quality of their life moving forward. Prognostication, with regard to both survivability and quality of life, is impacted by several features that include, but are not limited to, patient demographics, clinical features on presentation, and over time, access to therapy, and access to multidisciplinary clinics. An understanding of the impact that these features have on the life of a patient with ALS can help providers to develop a better and more personalized approach for patients related to their clinical prognosis after a diagnosis is made. The ultimate goal of prognostication is to empower patients with ALS to take control and make decisions with their care teams to ensure that their goals are addressed and met.

Keywords

ALS - prognosis - quality of life - palliative care - multidisciplinary clinic


Publication History

Article published online:
26 September 2023

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