Amyotrophic lateral sclerosis is a chronic disease involving essentially the old and new motor systems, namely the anterior horn cells and the pyramidal tracts. The disease, which affects older adults and persons past middle age, is regarded as a degenerative one of unknown etiology. It is relentlessly progressive. It generally begins in the upper extremities with loss of power, atrophies and fibrillations, and when it ascends, as it generally does, to the medulla it terminates fatally. The duration is from one to two years, longer if the disease begins in the lower extremities. As far as is known there are no remissions, there is no treatment and there is no cure. The neurologic characteristic of the disease is a combination of paralysis and atrophy with increased deep reflexes. In every other disease in which the anterior horn cells are affected, the deep reflexes are invariably lost in the affected limb.
WECHSLER IS. RECOVERY IN AMYOTROPHIC LATERAL SCLEROSIS: TREATED WITH TOCOPHEROLS (VITAMIN E): PRELIMINARY REPORT. JAMA. 1940;114(11):948–950. doi:https://doi.org/10.1001/jama.1940.02810110014007
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