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Treatments and drugs
By Mayo Clinic staffThe treatments for primary lateral sclerosis focus on relieving symptoms and preserving function. There are no treatments to prevent, stop or reverse PLS. Treatments include:
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Medication. Drugs are available to relieve muscle spasms (spasticity), including baclofen, tizanidine (Zanaflex), diazepam (Valium) or clonazepam (Klonopin). These medications are taken orally. If your spasticity isn't controlled with oral medication, your doctor may recommend surgically implanting a medication pump to deliver baclofen directly to your spinal fluid (intrathecal baclofen).
Other medications may be prescribed to treat cramps or pain related to spasticity, including phenytoin (Dilantin) or analgesics.
- Physical therapy. Stretching and strengthening exercises will help to maintain muscle strength, flexibility and range of motion, and to prevent joint immobility. Massage or therapeutic whirlpools also may provide relief from PLS symptoms.
- Speech therapy. If your facial muscles are affected by PLS, speech therapy can help you compensate for the effect on your speaking patterns.
- Assistive devices. You may be evaluated periodically by physical or occupational therapists to determine whether you need assistive devices, such as a cane, walker or wheelchair, as PLS progresses.
- NINDS primary lateral sclerosis information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/primary_lateral_sclerosis/primary_lateral_sclerosis.htm. Accessed Aug. 17, 2010.
- Juvenile primary lateral sclerosis. National Institutes of Health Genetics Home Reference. http://ghr.nlm.nih.gov/condition=juvenileprimarylateralsclerosis. Accessed Aug. 16, 2010.
- Murray B, et al. Disorders of upper and lower motor neurons. In: Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-7506-7525-3..50116-3&displayedEid=4-u1.0-B978-0-7506-7525-3..50116-3--cesec19&uniq=215117994&isbn=978-0-7506-7525-3&sid=1040472768. Accessed Aug. 16, 2010.
- Brugman F, et al. Adult-onset primary lateral sclerosis is not associated with mutations in the ALS2 gene. Neurology. 2007;69:702.
- Tartaglia MC, et al. Differentiation between primary lateral sclerosis and amyotrophic lateral sclerosis: Examination of symptoms and signs at disease onset and during follow-up. Archives of Neurology. 2007;64:232.
- Gordon PH, et al. Clinical features that distinguish PLS, upper motor neuron-dominant ALS, and typical ALS. Neurology. 2009;72:1948.
- Hadano S, et al. Molecular and cellular function of ALS2/alsin: Implication of membrane dynamics in neuronal development and degeneration. Neurochemistry International. 2007;51:74.
- Motor neuron diseases fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/motor_neuron_diseases/detail_motor_neuron_diseases.htm. Accessed Aug. 17, 2010.
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