Abstract
<jats:title>Abstract</jats:title> <jats:p>This chapter evaluates motor progression in amyotrophic lateral sclerosis (ALS). Rates of progression of muscle weakness vary markedly among patients, from very rapid (less than 1 year from onset to death) to very slow (many years between onset and death). It is not possible to know when the first motor neuron dies, and ALS duration is measured from when the patient first recognized the occurrence of symptoms. The chapter then discusses some of the formal measures of ALS progression, particularly the measurement of muscle strength with the MRC scale (Medical Research Council), as well as the ALS Functional Rating Scale–Revised (ALSFRS-R). It examines the King’s College Staging scale, which is perhaps the most used staging scale for ALS, before considering discussions of care choices and goals of care to meet the challenges of ALS progression.</jats:p>