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August 1979

Reduced Flow Rates in Amyotrophic Lateral Sclerosis

Arch Neurol. 1979;36(8):523. doi:10.1001/archneur.1979.00500440093025

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To the Editor.—  I would like to commend Fallat et al, the authors of "Spirometry in Amyotrophic Lateral Sclerosis" (Archives 36:74-80, 1979), as well as the Archives itself for publishing the paper. The data are comparable to and compatible with those generated at this center over the past two decades. We particularly agree with the following observation:It is noteworthy that gas exchange is so well maintained even with severe deterioration in spirometry. Therefore, arterial blood gas measurements are not necessary, nor are they particularly useful in following up this disease unless lung function becomes additionally compromised with infection, aspiration, or congestive heart failure.I would differ with the authors in characterizing the changes in flow, forced vital capacity, maximum voluntary ventilation, and forced expiratory volume as indicating obstructive disease. It is directly attributable to muscle weakness, which is the basis of all neuromuscular restrictive disease.We conceive of the

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