Strategies for improving hydration in patients with amyotrophic lateral sclerosis/motor neuron disease

Amyotrophic lateral sclerosis (ALS) is one of the forms of motor neuron disease (MND), characterized by its degenerative neurological nature, with progressive involvement of upper and lower motor neurons, leading to atrophy, paralysis, and weakness of the appendicular and bulbar muscles. The bulbar changes presented by the patient are dysphonia, dysarthria, dyspnea, and dysphagia and can start the clinical condition in about 25% of cases. The hydration of patients with ALS can be compromised by several factors, such as dysphagia for liquids, inappetence, and cognitive, metabolic, mechanical, and neuromotor alterations. The clinical implications of a dehydration condition for the patient can be devastating, bringing complications that, themselves, can be easily avoided. For this reason, the team must be very attentive to early identification and proper treatment of dehydration. In this chapter, several clinical aspects related to the theme of hydration in amyotrophic lateral sclerosis will be addressed.