3. Симптоматическое лечение мышечной слабости

а. Мышечная слабость компенсируется механическими приспособлениями. Например, воротник помогает удерживать голову при слабости шейных мышц, а бинтование запястий облегчает захватывание предметов руками при слабости разгибателей кисти.

б. Моторизованные или механические приспособления (кресла-каталки, лифты, функциональные кровати) уменьшают потребность в посторонней помощи.

в. Фиксаторы стопы при боковом амиотрофическом склерозе обычно не применяют, однако при болезни Кугельберга—Веландер, характеризующейся медленным прогрессированием, они могут быть полезны.

г. ЛФК замедляет развитие атрофии от бездействия и предупреждает контрактуры. Необходимо избегать переутомления и расходовать силы прежде всего на повседневные нужды, а не на бесполезные попытки «увеличить мышечную массу».

д. Для уменьшения часто встречающихся при боковом амиотрофическом склерозе судорог используютфенитоин(300 мг/сут) илидиазепам(по 2—10 мг 3 раза в сутки). Положительный эффект оказывают также тепловые процедуры и массаж.

4. Содержание больных в стационаре требует больших средств. В большинстве случаев лечение можно проводить в домашних условиях с участием приходящих медицинских сестер и других работников социальной сферы. Однако если родственники не могут обеспечить уход в домашних условиях, показана госпитализация в учреждение для помощи умирающим.

5. Чтобы следить за динамикой заболевания и своевременно выявлять осложнения, регулярно измеряют вес и ЖЕЛ, проверяют сохранность кашлевого рефлекса и глотания.

6. Самоубийства происходят редко — возможно, из-за физической немощи.

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