Primary Lateral Sclerosis

　　1. Genetic factors, research shows that the disease has certain genetic factors.

　　2. The etiology and pathogenesis of some cases are related to the following factors:

　　(1) Toxic factors: Excitotoxic neurotransmitters such as glutamate may be involved in the death of neurons in ALS, possibly due to a reduction in the uptake of glutamate transported by the glutamate transporter of astrocytes.

　　(2) Immunological factors: Various antibodies and immune complexes have been detected in the patient's serum.

　　(3) Viral infection: Since acute poliomyelitis invades the anterior horn motor neurons of the spinal cord, it may be related to chronic infection with poliomyelitis or poliomyelitis-like viruses.

　　This disease mainly manifests as spastic paralysis of the lower limbs, scissors gait, increased muscle tone, hyperreflexia, and Babinski sign, etc. A few cases may start from the lower limbs and gradually involve both upper limbs. In the late stage, there may be bulbar palsy, even if there is severe dysfunction of the brainstem, the extraocular muscles are not affected. As the course of the disease progresses, patients may also develop respiratory muscle paralysis or respiratory tract infection, leading to death in the end; the survival period of this disease ranges from a few months to more than a decade, with an average of 3-5 years.

　　Firstly, symptoms:

　　1. Spastic paraplegia: characterized by symmetrical weakness and rigidity in both lower limbs, walking with a spastic gait, gradually involving both upper limbs. Generally, there is increased muscle tone, hyperreflexia, and more pronounced in the lower limbs, with positive pathological reflexes. In the late stage, there may be urinary incontinence.

　　2. There is no muscle atrophy and fasciculation.

　　3. Objective sensation is normal, and there are no changes in consciousness and intelligence.

　　Secondly, auxiliary examinations:

　　1. Cerebrospinal fluid examination is mostly normal.

　　2. Electromyography shows neuronal damage.

　　1. Combine work and rest, and maintain regular living habits.The onset of primary lateral sclerosis is closely related to overexertion. Patients with this disease often suffer from overexertion, excessive eye strain, round-the-clock labor, or irregular living habits due to frequent travel, which consumes Qi and blood, leading to a decline in physical fitness. External pathogens take advantage of the weakness to cause the onset and development of the disease. Therefore, during the recovery process, patients must maintain regular living habits and combine work and rest. Only in this way can they cooperate with drug treatment, gradually enhance their physical fitness, and recover health as soon as possible.

　　2. Vitalize the spirit and maintain emotional comfort.The occurrence of this disease is often related to the patient's long-term mental tension or excessive thinking, sadness, and other emotional changes. If the patient's emotional fluctuations are frequent during the recovery period, it can often lead to the development or deterioration of the disease. Therefore, during the treatment and recovery process, patients must pay attention to mental nourishment, maintain mental peace and purity, avoid greed and delusion, and allow the true Qi to flow smoothly, with the spirit staying internally. Only in this way can the disease be cured as soon as possible.

　　3. Reasonable diet, do not偏嗜.Reasonable diet and adequate nutrition are necessary conditions to ensure human growth and development

　　1. Neuroelectrophysiology:Electromyogram shows typical neurogenic changes. In the resting state, fibrillation potential and positive sharp waves can be seen, and sometimes fasciculation potential can be seen; during small force contraction, the duration of motor unit potential increases, the amplitude increases, and the multiphasic waves increase, and during large force contraction, it presents a simple phase. Nerve conduction velocity is normal. Motor evoked potential is helpful to determine the damage of upper motor neurons.

　　2. Muscle biopsy:It is helpful for diagnosis, but not specific, early as neurogenic muscle atrophy, late under the light microscope and myogenic muscle atrophy is not easy to distinguish.

　　3. Other:Blood biochemistry, CSF examination is usually normal, creatine kinase (CK) activity may be slightly abnormal, MRI can show that some cases of involved spinal cord and brainstem atrophy and shrinkage.

　　1. Eat more vegetables such as sprouts, spinach, cabbage, radish, tomatoes, etc. Drink sweet spring water, lemon juice, and other beverages, especially milk and rich milk are the best. Fruits should be eaten more often, such as hawthorn, jujube, tangerine, etc.

　　1. People with drinking habits can drink moderate amounts of fruit wine, such as red wine, beer, etc. Food should be in moderation, not偏嗜. Avoid overeating and binge eating, especially high-sugar foods, for patients with periodic paralysis, whose clinical manifestations are recurrent episodes of general paralysis, should be禁忌.

　　1. Etiological treatment

　　(1) Treatment for excitatory amino acid toxicity. (2) Neurotrophic factor treatment. (3) Free radical scavengers and antioxidant treatment.

　　2. Symptomatic treatment:Symptomatic treatment can improve the quality of life of patients.

　　3. Psychological treatment:

　　4. Rehabilitation treatment:Active rehabilitation treatment can improve patients' motor ability, maintain joint mobility, prevent atrophy due to disuse, and enable patients to maximize their existing functions.

　　5. Prevention and treatment of respiratory failure in end-stage patients.