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• Vol.53 No.2
• CLINICA NEUROL, 53: 98−103, 2013
• Vol.53 No.2 contents

Original Article

Communication disorder in amyotrophic lateral sclerosis after ventilation
-A proposal of staging and a study of predictive factor-

Kentaro Hayashi, M.D.¹⁾, Yoko Mochizuki, M.D.²⁾³⁾, Yuki Nakayama, R.N., Ph.D.⁴⁾, Toshio Shimizu, M.D.¹⁾, Akihiro Kawata, M.D.¹⁾, Masahiro Nagao, M.D.¹⁾, Toshio Mizutani, M.D.²⁾⁵⁾ and Shiro Matsubara, M.D., Ph.D.¹⁾

¹⁾Department of Neurology, Tokyo Metropolitan Neurological Hospital
²⁾Department of Pathology, Tokyo Metropolitan Neurological Hospital
³⁾Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled
⁴⁾Laboratory of Nursing Research for Intractable Disease, Tokyo Metropolitan Institute of Medical Science
⁵⁾Fuchu Medical Center for the Disabled

ALS patients supported by a ventilator often suffered from difficulty in communicating with others. We herein proposed a new classification of clinical stages of advanced ALS focusing on the degree of communication disturbance. We analyzed the relationship between clinical findings and the prognosis for communication disturbance. Twenty-nine ALS patients without dementia were enrolled in the study. The proposed classification consisted of five stages. Stage I: communicate in sentences, stage II: communicate with one word answers only, stage III: communicate with nonverbal yes/no response only, stage IV: cannot communicate occasionally due to uncertain yes/no responses, stage V: cannot communicate by any means. Clinical analysis showed that patients who reached stage V had begun to use the ventilator significantly earlier than patients with the final stages of IV or less. In addition, patients in stage V frequently had a family history of ALS. Rapid disease progression before ventilator use in patients with a family history might predict a poor long-term prognosis for communication disorder after using the ventilator.
Full Text of this Article in Japanese PDF (1276K)

(CLINICA NEUROL, 53: 98−103, 2013)
key words: amyotrophic lateral sclerosis, communication ability, clinical staging, tracheostomy positive pressure ventilation(TPPV), totally locked-in state (TLS)

(Received: 14-Mar-12)