Roche et al reported a clinical staging system for patients with amyotrophic lateral sclerosis (ALS). The authors are from King's College London, Universitat Autonoma de Barcelona, Oxford University and University of Sussex.
Patient selection: amyotrophic lateral sclerosis (ALS)
Site of onset:
(1) limb
(2) bulbar
(3) diaphragmatic
CNS regions:
(1) bulbar
(2) upper limb
(3) lower limb
(4) diaphragmatic
Milestones:
(1) symptom onset (weakness, wasting, spasticity)
(2) diagnosis
(3) functional involvement of second CNS region
(4) functional involvement of third CNS region
(5) gastrostomy needed
(6) non-invasive ventilation needed
Milestone
Stage
onset
1
diagnosis
2A
second region involved
2B
third region involved
3
gastrostomy
4A
non-invasive ventilation
4B
Survival over time decreases with increases of each stage.
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