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Amyotrophic lateral sclerosis

L P Rowland1

  • 1Neurological Institute, Columbia-Presbyterian Medical Center, New York, NY 10032-2603.

Current Opinion in Neurology
|August 1, 1994
PubMed
Summary
This summary is machine-generated.

Amyotrophic lateral sclerosis (ALS) trials show limited success. Riluzole, a glutamate antagonist, offered some benefit for bulbar-onset ALS, while multifocal motor neuropathy responded well to intravenous immunoglobulin therapy.

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Area of Science:

  • Neuroscience
  • Neurology
  • Clinical Trials

Background:

  • Amyotrophic lateral sclerosis (ALS) therapeutic trials have yielded limited success.
  • Key pathogenesis theories include autoimmunity, glutamate excitotoxicity, and familial ALS-related oxidative stress.
  • Previous drug trials for ALS have largely been ineffective.

Purpose of the Study:

  • To review the current state of therapeutic trials for amyotrophic lateral sclerosis (ALS).
  • To highlight the efficacy of riluzole, a glutamate antagonist, in specific ALS patient subgroups.
  • To present promising results from intravenous immunoglobulin therapy in multifocal motor neuropathy (MMN).

Main Methods:

  • Review of existing therapeutic trial data for ALS.
  • Analysis of riluzole's effects based on onset type (bulbar vs. spinal).

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  • Summary of recent findings on intravenous immunoglobulin therapy for MMN.

    • Main Results:

    • Riluzole demonstrated potential benefit in patients with bulbar-onset ALS, but not spinal-onset.
    • Multifocal motor neuropathy (MMN), a condition mimicking motor neuron disease, showed positive responses to therapy.
    • Three independent groups reported successful outcomes using intravenous immunoglobulin for MMN.

    Conclusions:

    • Current ALS therapies remain largely ineffective, necessitating further research.
    • Riluzole's specific benefits warrant further investigation and clarification of trial parameters.
    • Intravenous immunoglobulin therapy presents a promising avenue for treating MMN, a condition with clinical similarities to ALS.