Amyotrophic lateral sclerosis: a team approach to primary care

Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes degeneration of motor neurons and results in death. The most frequent presenting symptom of patients with ALS is muscle weakness. The role of the nurse practitioner (NP) in the diagnosis and management of ALS is multifaceted. The NP could serve as the coordinator of care provided by a multidisciplinary team or as a member of the team. The coordinator of the team may vary depending on the individual needs of the patient with ALS and the stage of illness. Muscle weakness and spasticity, respiratory difficulties, and speech and swallowing problems are frequently encountered problems needing intervention. The role of the NP is important in providing symptomatic relief for the patient, and essential in providing education and psychosocial support for the patient and family caregivers. This article reviews the pathophysiology, assessment, management, and recent advances in research related to ALS. The challenging role of the NP in improving the quality of life of patients with ALS and their families is discussed.