Abstract

Typical onset of Amyotrophic Lateral Sclerosis includes a combination of upper and lower motor neuron signs. Respiratory failure is a frequent end-stage complication of the disease. However, in limited number of cases, severe hypoventilation is reported as the first manifestation of Amyotrophic Lateral Sclerosis. Here we present a 39 -year old man were referred to our chest ünite with 8-month history of severe dyspnea on exertion and lying flat which had progressively worsened. A diagnosis of Amyotrophic Lateral Sclerosis was made after neurologic evaluation and electromyographic study. We suggest that Amyotrophic Lateral Sclerosis should be considered in patients with unexplained respiratory failure.