Although primary lateral sclerosis begins in the legs, it progresses to affect the muscles of the hands and at the base of the brain. As a result, affected individuals may also exhibit difficulty forming words (dysarthria) and difficulty swallowing (dysphagia). In some cases, these symptoms may precede the development of muscle weakness in the legs.
Stiffness was the only symptom that was significantly effective in patients with PLS (observed in 47% and 4% of patients, respectively; P<.001). During follow-up, limb wasting was rare in patients with PLS (2%, compared with 100% in patients with ALS; P<.001). During the 16 years of follow-up, the mortality rate was significantly lower in patients with PLS compared with patients with ALS (only 33% vs 89%, respectively; P<.001).
Allopathic physicians generally treat PLS for spasticity using drugs that include baclofen and the benzodiazepines, such as clonazepam (Klonopin). They also may provide antidepressants when indicated for depression. In contrast, chiropractors can provide adjustments coupled with soft-tissue movement to improve optimum functioning, alleviate spasticity, promote increased range of joint motion.