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Updated: Apr 23, 2026

A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis ALS
Published on: February 21, 2011
Amyotrophic lateral sclerosis presenting respiratory failure as the sole initial manifestation
Fuyuki Tateno1, Ryuji Sakakibara1, Kengo Kawashima2
1Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
Abstract:
It is rare that amyotrophic lateral sclerosis (ALS) presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness.
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