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Algorithm for Diagnosing ALS
World Federation of Neurology (WFN) criteria have been shown to be efficient and
accurate and can be used to accelerate ALS diagnosis 1
Criteria for Early ALS Diagnosis2,3
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Important Treatment Considerations
- Evaluate serum ALT levels every month during the first 3 months
of treatment, and every 3 months during the remainder of the first year. Thereafter,
serum ALT levels should be periodically evaluated more frequently in patients who
develop elevations. Rilutek should be discontinued if ALT levels increase to 5 times
ULN or if clinical jaundice develops.
- Advise patients about the potential for dizziness, vertigo, or
somnolence and not to drive or operate machinery until they have sufficient experience
on Rilutek.
- Advise patients to report any febrile illness; measure WBCs.
- Use Rilutek with caution in patients with concomitant liver insufficiency;
caution should be exercised when prescribing Rilutek to patients taking drugs that
are potentially hepatotoxic or highly protein bound:
- Interactions may also occur when riluzole is given concurrently
with agents that affect hepatic CYP 1A2 activity.*
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References
- Bromberg M. Accelerating the diagnosis of amyotrophic lateral sclerosis. The
Neurologist. 1999;5:63-74.
- El Escorial Revisited. revised criteria for the diagnosis of amyotrophic lateral
sclerosis. World Federation of Neurology Web site. Available at http://www.wfnals.org/guidelines/1998elescorial/elescorial1998criteria.htm.
Accessed May 10, 2007.
- Brooks BR, Miller RG, Swash M, Munsat TL, for the World Federation of Neurology
Research Group on Motor Neuron Diseases. El Escorial revisited: revised criteria
for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other
Motor Neuron Disorder.
2000;1:293-299.
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