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The course of the terminal phase in patients with amyotrophic lateral sclerosis

Neudert, Christian, Oliver, David J., Wasner, Maria, Borasio, Gian Domenico (2001) The course of the terminal phase in patients with amyotrophic lateral sclerosis. Journal of Neurology, 248 . pp. 612-616. ISSN 0340-5354. (doi:10.1007/s004150170140) (KAR id:67072)

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The fear of “choking to death” is on the mind of most patients suffering from amyotrophic lateral sclerosis (ALS). So far, however, there have been no systematic surveys concerning the dying phase in a general ALS population. We therefore performed a structured telephone interview with the relatives of 121 patients who died from ALS and were followed by the Motor Neuron Outpatient Clinic of the Department of Neurology, University of Munich, Germany. These data are compared with those obtained by a retrospective analysis of medical records of 50 ALS patients who were followed by the Wisdom Hospice, Rochester, UK.

The data show that most ALS patients (Germany 88 %, UK 98 %) died peacefully, and no patient “choked to death”. The symptoms most frequently reported for the last 24 hours were dyspnoea, coughing, anxiety and restlessness. Around half (G 55 %, UK 52%) of the patients died at home. The main palliative measures in place during the terminal phase were: home mechanical ventilation (G 21 %, UK 0 %), percutaneous endoscopic gastrostomy (G 27 %, UK 14 %), morphine (G 27 %, UK 82 %) and benzodiazepines (G 32%, UK 64 %). The use of these palliative measures was judged to be beneficial by almost all relatives. These data support the hypothesis of a peaceful death process in ALS and should be communicated to patients and their relatives, at the latest after the onsetof dyspnoea, to relieve unwarranted fears.

Item Type: Article
DOI/Identification number: 10.1007/s004150170140
Uncontrolled keywords: amyotrophic lateral sclerosis, terminal phase, palliative care,death, choking
Subjects: R Medicine
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Tizard
Depositing User: David Oliver
Date Deposited: 17 May 2018 10:35 UTC
Last Modified: 16 Nov 2021 10:25 UTC
Resource URI: (The current URI for this page, for reference purposes)

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Oliver, David J..

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