Amyotrophic Lateral Sclerosis (ALS) - CRASH! Medical Review Series

(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)

Пікірлер: 107

  • @kennethbarkhurst5390
    @kennethbarkhurst53905 жыл бұрын

    I was diagnosed with ALS last August 2018 by my Neurologist. Went for a 2nd opinion from another Neurologist. He didn't think that I have ALS. Had a EMG test with the first Neurologist. The 2nd Neurologist sent me also for an EMG test with another Neurologist. After the test, the test Neurologist said things were very complicated, but he also felt I had ALS. After that I was sent to another Neurologist who was ALS Certified for an ALS Workshop. After all the tests at the Workshop, I finally saw and talked with the Neurologist. She was an older woman, definitely in her 50''s or early 60's. We talked, and I explained the issue's from all three other Neurologists. So she reviewed all the findings of all 3 other Neurologists. Plus all the blood work, and the 5 CT Scans of my head and back. My lower leg's and feet were still good, as was my upper body. The ALS Certified Neurologist asked me about my family and my personal medical History. One thing that got her attention was that I had Infantile Paralysis as a young kid. She then brought up Post Polio Syndrome. Which is often misdiagnosed as ALS. So as of now, I am still being tested to determine what is my problem. I was originally diagnosed with Lumbar Spinal Stenosis. So she just had me do another CT Scan, and is looking into also during a Muscle Biopsy on me also. I have now been going to my medical group for a year, and still no definitive answers. So if anyone of you have a History of Polio, don't totally accept an ALS diagnosis, until the possibility of Post Polio Syndrome is looked into. Because Post Polio mimics ALS.

  • @SOS-School_Of_Survival

    @SOS-School_Of_Survival

    5 жыл бұрын

    Very interesting thank you for sharing. Any more information to share?

  • @xDomglmao

    @xDomglmao

    5 жыл бұрын

    Thank you very much for sharing! Will keep this in mind.

  • @Xinoserrot77

    @Xinoserrot77

    3 жыл бұрын

    Thank you for your testimony. Any updates?

  • @philosophia4562

    @philosophia4562

    Жыл бұрын

    If there is still uncertainty surrounding your diagnosis I would encourage you to explore Lyme Disease. It can often mimic ALS. Best of luck to you.

  • @briannabogans4608
    @briannabogans46083 жыл бұрын

    This was a wonderful presentation.

  • @user-et9mf8qe9o
    @user-et9mf8qe9o6 жыл бұрын

    great video. thanks for the effort

  • @DeepakSharma-ow5pj
    @DeepakSharma-ow5pj6 жыл бұрын

    Great Presentation!

  • @dr.ciyowabdiadam4850
    @dr.ciyowabdiadam48502 жыл бұрын

    Very amazing lecture.

  • @tahooratahmasebi7033
    @tahooratahmasebi70333 жыл бұрын

    Your lectures are really helpful. Thank you so much 🌸

  • @nystagmus
    @nystagmus6 жыл бұрын

    This is great I have a patient with primary lateral sclerosis (PLS) and that can be on the differential too.

  • @bruceroseman5616

    @bruceroseman5616

    Жыл бұрын

    Thank you for expanding the differential diagnosis of disease most of us consider a dead end before we complete a differential approach

  • @summerxia7474
    @summerxia74747 жыл бұрын

    Really useful review! Thx~

  • @AnmoldeepKaur-gm3mi
    @AnmoldeepKaur-gm3mi4 ай бұрын

    Great lecture,Thankyou so much!

  • @marwaa2895
    @marwaa28953 жыл бұрын

    Great presentation 👏 thank you sir

  • @woloabel
    @woloabel Жыл бұрын

    Neurology: Amyotrophic Lateral Sclerosis (ALS) is a Degenerative Disease, an Exclusively Progressive Neurological Deterioration of Both Upper Motor Neurons (UMNs) and Lower Motor Neurons (LMNs), and a Terminal Illness. Pathophysiology: Lateral Corticospinal Tract Degeneration (Most visible Autopsy Finding upon Histological Examination of the Spinal Cord). Pathogenesis is Insidious and Unrelenting Onset and Progression. Epidemiology: 1) 5,600 Annual Incidence. Aetiology is Idiopathic Causation. SSx: UMNs: 1) Primitive Reflexes as in Babinski Sign (Dorsiflexion of the Toes upon stimulation), 2) Hyperreflexia, 3) Spasticity, 4) Hypertonia, 5) Clasp-knife Reflex (Rigidity upon Physician's Attempt to Move the Arms of Patient Downward), 6) Pronator Drift; LMNs: 1) Fibrillation of Muscles, 2) Fasciculations of Muscles, 3) Hypotonia of the Muscle, 4) Hyporeflexia of the Muscle, and 5) Muscle Weakness (Myasthenia); Cranial Nerve Involvement: CN V (Trigeminal Nerve), CN VII (Facial Nerve), CN IX (Glossopharyngeal Nerve), CN X (Vagus Nerve), CN XII (Nervus Hypoglossus/Hypoglossal Nerve) yielding Dysarthria or Nasal Speech; CN X Involvement will show Hoarseness while CN X and CN XII will yield Dysphagia, a Difficulty in Swallowing and Choking. This Pathology also manifests a Pseudobulbar Affect Syndrome (PAS) or Inappropriate and Involuntary Laughing and Crying Presentation. Other symptoms: 1) Tripping (Limb and Gait Manifestations), 2) Stumbling, 3) Limp, 4) Hand Fatigue, 5) Cramping, 6) Stiffening (Ongoing and Progressive History). Uninvolved Musculature: 1) Bowel Muscles are unaffected, 2) Bladder Muscles are also not involved or Conserved. 3) Extraocular Muscles are intact. History (Hx): Family history (FHx) can be a Factor in ALS. Px: 1) Noticeable Limb Weakness, 2) Positive Babinski Sign, 3) Gait Abnormalities, 4) Muscle Atrophy, and 5) Nasal Speech; Diagnosis (Dx): 1) Clinical Diagnosis; 2) Most Accurate Test is an Electromyography (EMG); 3) Muscle Biopsy may be useful to Exclude other Possible Diagnoses. DDx: 1) Spinal Muscle Atrophy (SMA) is an LMN Symptoms and often Presents in Younger Patients or Infants. A Babinski Sign is Negative or Not Present; 2) Spinal Canal Stenosis has Sensory Symptoms; 3) Stroke will have an Acute Onset and will have inherent Risk Factors Present; 4) Guillan-Barre Syndrome (GBS) has an Acute Onset and will have a Characteristic CSF Morphology (High Protein without Cells); 5) Myasthenia Gravis (MG) has an Acute Onset and Involves the Extraocular Muscles and a History will show Autoimmune Likelihood (Autoimmune History: 1) Diabetes Mellitus Type I, 2) Rheumatoid Arthritis; 3) Crohn's Disease; 4) Systemic Lupus Erythematosus (SLE)). Prognosis is Poor with a 3 to 5 year Fatality Probability and Cause of Death is usually Aspiration Pneumonia (AP), a common Complication of ALS. Tx: 1) Supportive Treatment only as there is no known Cure for ALS; 2) NMDA Inhibitor Riluzole; 3) Muscle Relaxants Baclofan or Tizanidine for Muscle Spasm or Cramps; 4) Dextromethorphan/Quinidine for PBS; 5) Physical Therapy (PT) for Painful Contractures (LIgaments). 6) Anticholinergics for Excessive Salivation/Drooling; 7) Percutaneous Endoscopic Gastrostomy (PEG) Intubation for Feeding (Late Stage Treatment); 8) Non-Invasive Ventilatory Support for Muscle Weakness (Respiratory Distress of Late Stage); 9) Palliative Care Consultation (End of Life Planning) for Grief and Denial Possibility; and 10) Neurology Consultation. Code Status/Do-Not-Intubate (DNI) if appropriate should be attained. Goodness, My first ALS patient simply wanted an unimpeded Exit, without grief and turmoil but current Policy bars this approach. So Sad. Euthanasia must be. MD Paul Bolin, es geht immer gut aber diese Krankheit traurige und grosse ist. Prost!

  • @HafizahHoshni
    @HafizahHoshni6 жыл бұрын

    Amazing! I am so thankful for sharing your expertise and knowledge. Thank you so much! 11/8/2018

  • @abdulrasheedhamisu7368

    @abdulrasheedhamisu7368

    4 жыл бұрын

    True..how u?

  • @Gamafoi1

    @Gamafoi1

    3 жыл бұрын

    @@abdulrasheedhamisu7368 fine

  • @gavinbelly370

    @gavinbelly370

    3 жыл бұрын

    A lot of people believe that ALS has no cure, but i must tell you a great source of ALS cure permanently, I was diagnosed of ALS early this year. I had severe symptoms ranging from shortness of breath, balance problems, couldn't walk without a walker or a power chair, i had difficulty swallowing and fatigue. I was given medications which helped but only for a short burst of time, then i decided to try alternative measures and began on ALS/MND Formula treatment from Dr James Ehimare herbal centre , It has made a tremendous difference for me, contact him via email (jamesherbalformula@gmail.com ). I had improved walking balance, increased appetite, muscle strength, improved eyesight and others. Don't hesitate to contact him for help call/whatsapp +2349057856543 you can tell him i recommend you to him. regards Gavin

  • @princessz5087
    @princessz50872 жыл бұрын

    Great video 🌹👍

  • @themostgraciousqueenmarger2015
    @themostgraciousqueenmarger20154 жыл бұрын

    Why doesn't anyone use a cause and effect approach to identifying the source of a problem rather than always trying to get a diagnosis?

  • @srankurlal4588
    @srankurlal45888 жыл бұрын

    best review sir

  • @drabdirahmansaladibrahim4602
    @drabdirahmansaladibrahim46027 жыл бұрын

    what about DDX of : 1) Cervical spodylosis 2) Myopathies reply needed.....

  • @corinnastark713
    @corinnastark7133 жыл бұрын

    I have some problems with twitching all over my body, it started above my right knee and days later it was all over my body, feet, on different part of my legs, upper arms, shoulders, back, and stomach... I already went for a nerve conduction velocity which was fine , I wonder if ALS can start with twitching on random parts on the body ?

  • @jeffreyprice773
    @jeffreyprice773 Жыл бұрын

    In UK it's called motor neuron disease, MND.

  • @nyamurungibtumusiime4562
    @nyamurungibtumusiime45625 жыл бұрын

    Sounds like sheldon cooper lol...otw greeaatt video, thank you soo much!

  • @DrDinooshDeLivera
    @DrDinooshDeLivera5 жыл бұрын

    Thank you!

  • @kevinbeazy
    @kevinbeazy4 жыл бұрын

    My father in law was just diagnosed. Only been a few months since beating cancer. Weakness, trouble swallowing, getting winded very easily, shaking. Was told today at Emory that he’s probably had ALS for a couple years. 40% lung function.

  • @texastea5686

    @texastea5686

    3 жыл бұрын

    Hello. How is he doing today Sept 2020?

  • @ardademir7079

    @ardademir7079

    Жыл бұрын

    @@texastea5686 didnt you just watch the video?

  • @susangoodwin8067
    @susangoodwin80672 жыл бұрын

    My brother has ALS. How much research is focused on the cause?

  • @yashratanpal5317
    @yashratanpal53177 жыл бұрын

    Excellent

  • @bruceroseman5616
    @bruceroseman5616 Жыл бұрын

    Please include celiac disease common in the differential diagnosis Would you consider post polio syndrome in the differential diagnosis. I would think about using low-dose dexmethylphenidate facilitator for problems swallowing. Question: are there any common formulations I can exacerbate a nonsense mediated rna disorder I never ask my patients about whether they want to die , but do they have one reason To get out of bed in the morning they can, to live I would have all these patients valuated for nonsense mediated RNA decay disorder I thank you very much for putting together a well organized program making me think about what else I could do today to contribute to life Dr Bruce

  • @shkokurda2098
    @shkokurda20985 жыл бұрын

    What about the pathophysiology?

  • @charlieqian86
    @charlieqian862 жыл бұрын

    thanks for ur lectures🥰

  • @gamaltaher9714
    @gamaltaher97143 жыл бұрын

    Good, thanks

  • @aghaagha-et3if
    @aghaagha-et3if2 ай бұрын

    What a new treatment please tell me als mnd

  • @cjm38
    @cjm383 жыл бұрын

    Does tingling, numbness, and paresthesia present as beginning symptoms in some people with ALS?

  • @sebastianbehrens8370

    @sebastianbehrens8370

    3 жыл бұрын

    As far as I know no, not typically but rarely can present some sensory complaints

  • @liamomilano9398
    @liamomilano93988 жыл бұрын

    cheers Dr Bolin, another great video. seems like an easy DX?

  • @gianniangel388

    @gianniangel388

    2 жыл бұрын

    I know I'm kinda randomly asking but do anyone know of a good site to stream new tv shows online?

  • @jaceemiliano3047

    @jaceemiliano3047

    2 жыл бұрын

    @Gianni Angel Flixportal :D

  • @gianniangel388

    @gianniangel388

    2 жыл бұрын

    @Jace Emiliano thanks, I signed up and it seems to work :D Appreciate it !

  • @jaceemiliano3047

    @jaceemiliano3047

    2 жыл бұрын

    @Gianni Angel glad I could help :D

  • @chrystineblums6984

    @chrystineblums6984

    26 күн бұрын

    You may want to watch other videos. It is actually a difficult dx, one that is exclusionary

  • @harikrishnadubbasi3395
    @harikrishnadubbasi33953 жыл бұрын

    Now I treating this patient very bad experience

  • @oatv
    @oatv5 жыл бұрын

    Dr.Paul, at around 10:54, when you talk about the physical exam - I believe you meant "more APPENDICULAR weakness" (instead of axial) Great video, as always, saving my medical student career :)

  • @chmith27
    @chmith277 жыл бұрын

    haha most accurate test while the patient is alive..... "oh we were wrong- it was lou gehrig's other disease after all". just playing around great job man.

  • @drabdirahmansaladibrahim4602

    @drabdirahmansaladibrahim4602

    7 жыл бұрын

    i was just about to comment on that ..............what an irony lol

  • @Sugarblizz08

    @Sugarblizz08

    7 жыл бұрын

    Obviously you do not have a loved one with this disease or you would completely understand this line of thinking and how helpful it is.

  • @johnnyrascol2038

    @johnnyrascol2038

    6 жыл бұрын

    yeA fjck ya'll

  • @mathiasmjanger280
    @mathiasmjanger2805 ай бұрын

    why not call this disease stephen hawkings disease. I have no idea who that baseball player is

  • @ghirardellichocolate201
    @ghirardellichocolate2013 жыл бұрын

    Nice French Vanilla coffee?

  • @aneesfatima3431
    @aneesfatima34315 жыл бұрын

    gud video but there is no sound in d middle of d video.....plzzz upload videos which hav gud sound quality

  • @SaiKrishna-ew2wr

    @SaiKrishna-ew2wr

    5 жыл бұрын

    Anees Fatima try another browser

  • @somilsingh15
    @somilsingh155 жыл бұрын

    I hope you know about Stephen Hawking

  • @mavischadwick6445
    @mavischadwick64452 жыл бұрын

    Thanks so much Dr Alaho Olu on KZread first of all for who you are as a person thank you for the wonderful work that you do for people in general no matter where you are I will always listen to your podcast and refer people to you because you care about people and the human body I listen to other people but you talk about the true disturbances disorders that means things that are out of order in the human system thanks 🙏 for curing my Amyotrophic lateral Sclerosis disease (ALS)…

  • @somilsingh15
    @somilsingh155 жыл бұрын

    How Stephen Hawking Survived so long when als was first diagnosed at 21 years and he should be dead by 25 -26 , but he died at 76 ... Is he is not suffering from als if yes how did he lived so long

  • @bettygarcia2005

    @bettygarcia2005

    5 жыл бұрын

    Necesito qué pongan en español

  • @xDomglmao

    @xDomglmao

    5 жыл бұрын

    AFAIK he had a mild form.

  • @susanspann5731

    @susanspann5731

    Жыл бұрын

    He had a very rare slow progression form of ALS.

  • @rebeccaphillips2207
    @rebeccaphillips22076 жыл бұрын

    You are a lad

  • @jamiek6471
    @jamiek64715 жыл бұрын

    for me it's Stephen Hawking disease

  • @aghaagha-et3if
    @aghaagha-et3if2 ай бұрын

    What a new treatment please tell me als mnd