Letter to the Editor

Normal Chest Radiograph in Terminal Respiratory Failure Due to Amyotrophic Lateral Sclerosis

Authors: Christine Won, MD, Dipanjan Banerjee, MD, Paul Stark, MD, Ware G. Kuschner, MD

Abstract

We report the case of a patient with terminal respiratory failure due to amyotrophic lateral sclerosis (ALS) who had a normal chest radiograph (CXR) 13 hours before respiratory arrest and death. This case shows that a normal CXR in the setting of severe neuromuscular disease cannot be used as evidence of even short term respiratory stability.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Lechtzin N, Rothstein J, Clawson L, et al. Amyotrophic lateral sclerosis: evaluation and treatment of respiratory impairment. Amyotroph Lateral Scler Other Motor Neuron Disord 2002;3:5–13.
 
2. Schmidt-Nowara WW, Altman AR. Atelectasis and neuromuscular respiratory failure. Chest1984;85:792–795.
 
3. Rabinstein AA, Wijdicks EF. Warning signs of imminent respiratory failure in neurological patients.Semin Neurol 2003;23:97–104.
 
4. Similowski T, Attali V, Bensimon G, et al. Diaphragmatic dysfunction and dyspnoea in amyotrophic lateral sclerosis. Eur Respir J 2000;15:332–337.