Context Amyotrophic lateral sclerosis (ALS) is a group of rare neurological diseases which cause progressive loss of upper and lower motor neurons at the spinal or bulbar level. ALS affects voluntary muscles of the body which control eating, talking, and moving. Individuals with ALS manifest difficulty breathing on their own due to weakness of the respiratory system. The average life expectancy of individuals with ALS is 2–5 years from the time of diagnosis, with death resulting from respiratory failure. There is no cure for ALS. At present, riluzole and edaravone are the only FDA-approved treatments that impact survival. Adverse reactions to edaravone include hypoxia and respiratory failure. To date, there are no published reports describing isolated dramatic respiratory improvement in ALS with continued global clinical worsening including limb and face function, particularly following edaravone use.Findings We present a case report of late stage bulbar ALS, in which a dramatic respiratory improvement is seen following edaravone use, and subsequent cessation.Conclusion/Clinical Relevance Isolated pulmonary decline and subsequent recovery following cessation of edaravone in the setting of continued systemic neurologic decline has not yet been described and may suggest potential for reversibility of edaravone-related pulmonary decline. Research is needed to evaluate this possibility further, and this case report may lead to further investigation to evaluate this possibility. Alternatively, although less likely, it is possible the observed that pulmonary improvement may either be beneficially attributed to edaravone, or unrelated to edaravone entirely – representing an undescribed phenomenon of isolated pulmonary decline and improvement in the setting of systemic continued ALS progression, possibly related to the bulbar subtype. Further investigation is warranted to evaluate both the role of edaravone in causing in a potentially reversible pulmonary decline upon cessation of the medication, and the possibility of other undefined variables including various subtypes of ALS contributing to this phenomenon.

PM&RVolume 10, Issue 9S1 p. S68-S68 Poster 202: Onobotulinum A Injections in a Patient with Recurrent Shoulder Dislocation due to Deltoid Muscle Spasm: A Case Report Jungjae Lim MD, Jungjae Lim MD St Georges Univ, Syracuse, NY, United StatesSearch for more papers by this authorDavid Kanter MD, David Kanter MDSearch for more papers by this authorMargaret A. Turk MD, Margaret A. Turk MDSearch for more papers by this author Jungjae Lim MD, Jungjae Lim MD St Georges Univ, Syracuse, NY, United StatesSearch for more papers by this authorDavid Kanter MD, David Kanter MDSearch for more papers by this authorMargaret A. Turk MD, Margaret A. Turk MDSearch for more papers by this author First published: 26 September 2018 https://doi.org/10.1016/j.pmrj.2018.08.214Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume10, Issue9S12018 AAPM&R Annual Assembly AbstractsSeptember 2018Pages S68-S68 RelatedInformation