eMedicine Specialties > Neurology > Neuromuscular Diseases

Primary Lateral Sclerosis: Follow-up

Author: Carmel Armon, MD, MSc, MHS, Professor of Neurology, Tufts University School of Medicine; Chief, Division of Neurology, Baystate Medical Center
Contributor Information and Disclosures

Updated: Jun 8, 2009

Follow-up

Further Outpatient Care

Frequency of outpatient follow-up in patients with primary lateral sclerosis (PLS) depends on the patient's need for symptom control. It may range from monthly initially to every 4-6 months once optimal treatment is established (provided that no new symptoms appear).

Complications

Dysfunction and disability accrue as PLS progresses. These are dealt with by the treating physician as they arise.

Prognosis

  • Dysfunction and disability accrue slowly as PLS progresses. The median survival of patients with PLS is approximately 20 years.
  • Issues of progressive disability are shared by all patients with all forms of MNDs, regardless of type.

Patient Education

  • Physician's role
    • Distinction between PLS and other MND (particularly ALS) and the uncertainty of PLS evolving into ALS
    • Availability of fairly effective symptomatic treatment using a multidisciplinary approach
    • The possible (current or future) impairment or medication effects that would make driving, operating some types of machinery, and certain work environments (such as working on roofs or ledges) unsafe
  • Information resources for patients: These resources are listed for informational purposes. Listing these resources does not imply endorsement. Patients should obtain specific treatment recommendations from their physicians.

Miscellaneous

Medicolegal Pitfalls

PLS and its treatment may interfere with the ability to operate a motor vehicle (or other mechanical machinery) safely. The work environment should be reviewed for potential risks (eg, working on a roof or a narrow ledge). Patients with early PLS may not be limited in these respects, but they should be reassessed as the disease progresses.

  • Patients and physicians should follow the specific laws of their jurisdictions regarding notification of licensing authorities and automobile insurers.
  • Patients should be informed of these risks and counseled in accordance with the laws of their jurisdiction, taking their present and future condition into consideration. Such communications should be documented carefully.

 


More on Primary Lateral Sclerosis

Overview: Primary Lateral Sclerosis
Differential Diagnoses & Workup: Primary Lateral Sclerosis
Treatment & Medication: Primary Lateral Sclerosis
Follow-up: Primary Lateral Sclerosis
References
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References

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Further Reading

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Keywords

PLS, motor neuron disease, motoneuron disease, progressive spasticity, stiffness, MNDs, primary lateral sclerosis, upper motor neurons, lower motor neurons, ALS, amyotrophic lateral sclerosis, progressive muscular atrophy, PMA, spinal muscular atrophies, SMAs, degenerative diseases

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Contributor Information and Disclosures

Author

Carmel Armon, MD, MSc, MHS, Professor of Neurology, Tufts University School of Medicine; Chief, Division of Neurology, Baystate Medical Center
Carmel Armon, MD, MSc, MHS is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Association of Neuromuscular and Electrodiagnostic Medicine, American Clinical Neurophysiology Society, American College of Physicians, American Epilepsy Society, American Medical Association, American Neurological Association, American Stroke Association, Massachusetts Medical Society, Movement Disorders Society, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Paul E Barkhaus, MD, Professor, Department of Neurology, Medical College of Wisconsin; Director of Neuromuscular Diseases, Milwaukee Veterans Administration Medical Center
Paul E Barkhaus, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Neurological Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Neil A Busis, MD, Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside
Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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