ALS Neuromuscular Staging & Caregiver Pathway Navigator

Motor Unit Transmission Simulation

ACh Depletion: 45%

Upper Motor Neuron → Corticospinal → Anterior Horn LMN → NMJ

Disease Progression Timeline Month 14

Onset (Mo 0) Early Assistive (Mo 12-18) Complex Care (Mo 36+)

Stage 2 (Moderate Bulbar Involvement)

Total Score

36 / 48

Bulbar Domain

7 / 12

Fine & Gross Motor

17 / 24

Respiratory

12 / 12

1. Speech2/4

2. Salivation3/4

3. Swallowing2/4

4. Handwriting4/4

5. Cutting Food4/4

6. Dressing / Hygiene3/4

7. Turning in Bed3/4

8. Walking3/4

9. Climbing Stairs3/4

10. Dyspnea4/4

11. Orthopnea4/4

12. Resp. Insufficiency4/4

Proactive Phase

Bulbar communication preservation and aspiration prevention precautions

Clinical Staging Stage: Stage 2 (Moderate Bulbar Involvement)

Pulmonary Risk Index: Stable / Low Baseline

Bulbar Impairment Level: Moderate Dysarthria & Dysphagia

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