Abstract
Objective: To describe the clinical characteristics of amyotrophic lateral sclerosis (ALS) in patients treated at the Neurology Center, Bach Mai Hospital.
Subjects and Methods: A cross-sectional descriptive study was conducted on 52 ALS patients diagnosed according to the Gold Coast criteria at the Neurology Center, Bach Mai Hospital, from January 2024 to September 2025. Data were analyzed using SPSS 20.0; a p-value < 0.05 was considered statistically significant.
Results: The mean age was 57.65 ± 11.08 years (range: 32–79), with a male-to-female ratio of 1.36:1. No familial ALS cases were identified. The most common reason for hospital admission was hand weakness (51.9%), followed by dyspnea (5.8%). Lower motor neuron (LMN) signs predominated: muscle weakness (88.5%), atrophy (84.6%), fasciculations (61.5%), and cramps (53.8%). Upper motor neuron (UMN) signs included hyperreflexia (55.8%), increased muscle tone (48.1%), pyramidal signs (42.3%), and jaw jerk (19.2%). No sensory or sphincter disturbances were observed.
The mean time from symptom onset to diagnosis was 12.71 ± 18.41 months. Disease onset was cervical (59.6%), bulbar (25.0%), and lumbosacral (15.4%). Bulbar-onset patients were diagnosed earliest (6.15 ± 5.15 months), while lumbosacral-onset patients had the longest diagnostic delay (29.25 ± 31.74 months; p = 0.042). Longitudinal spread was predominant in bulbar-onset ALS (69.2%), whereas transverse spread was more frequent in spinal-onset ALS (48.7%) (p = 0.047).
Conclusion: In this cohort, ALS predominantly presented with cervical onset and lower motor neuron–predominant clinical features. Hand weakness was the most common initial symptom. Early recognition of onset site and progression pattern may help reduce diagnostic delay, improve prognosis, and optimize patient management strategies.