Credo for Creeping Paralysis

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Abstract
THREE years ago my husband developed the initial symptoms of amyotrophic lateral sclerosis (ALS). The diagnosis was determined clinically and unequivocally confirmed by electromyography. We were devastated by the diagnosis. Since we are both physicians, the full implications were immediately realized. The course that the illness followed was straight out of a textbook. Stiffness of the legs was followed by weakness. Footdrop developed first on the left, then on the right, and thereafter the disease process progressed inexorably to paralysis of the lower limbs. Weakness of the hands led quickly to global wasting of the small muscles and loss of function of the upper limbs. The paralysis extended more proximally, resulting in total quadraplegia. Bulbar symptoms followed with wasting of the tongue, dysarthria, dysphonia, and dysphagia. The most common response I have had from physicians who discussed the illness with me left me shocked and confused. A neurologist said, "It's

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