Obtaining Clinical Improvement in Amyotrophic Lateral Sclerosis with Stabilization of Progressive Functional Loss: Case Report Presentation and Review

Abstract

Background: The patient was given the diagnosis during evaluation at a comprehensive amyotrophic lateral sclerosis (ALS) center by the neurology team. During the year prior to the diagnosis of ALS the patient was evaluated by seven different neurologists over the course of the progressive disease. Coordinated evaluation refined the diagnosis to cryoglobulinemia causing a vasculitis that resulted in severe peripheral neuropathy. Case presentation: An 86-year-old female in general good health with insidious onset of symptoms that gained her classification qualification for an assigned diagnosis of amyotrophic lateral sclerosis. As frequently associated with a devastating diagnosis the patient and family remained motivated for any additional helpful options. Conclusion: Presented here is how the patient went from bedbound to assisted ambulation along with the complex medical evaluation, case details, exam findings, and additional medical information that allowed and hindered the patient's ability to recover. ALS remains one of the most devastating diagnosis that a patient could be given and the additional information in this case could be helpful to other patients. Described below is the thought process of a coordinated effort when presented with a diagnosis of exclusion.