PubMed · 9451203
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A R Klipper. Gout.. https://pubmed.ncbi.nlm.nih.gov/9451203/
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Primary lateral sclerosis (PLS) is a rare degenerative disorder of the upper motor neuron. Its nosological status and relationship to other motor neuron syndromes, especially amyotrophic lateral sclerosis (ALS), is uncertain. Diagnostic criteria have been proposed. We discuss the history of this rare clinical disorder, its relationship to the motor neuron disease syndrome, and reports of overlapping clinico-pathological conditions. Two patients with the clinical syndrome of PLS are described to illustrate current understanding of the clinical, laboratory, and neurophysiological features.
Erectile dysfunction can be devastating for men and for their partners. A good sexual history and focused physical examination can provide clues as to whether the underlying cause is psychogenic or organic. Diagnostic investigation should be tailored to the clinical picture. Oral medications now represent first-line therapy. Penile injection therapy and vacuum constrictive devices are reasonable choices for men in whom oral therapy falls or is contraindicated. The penile prosthesis provides a reliable long-term solution with high satisfaction rates. Psychotherapy may be indicated. Physicians can have a positive impact on the quality of life of patients by providing a non-judgmental and supportive environment for discussion and management of impotence.