Amyotrophic lateral scler...

An 81-year-old man with a spinal onset Amyotrophic lateral sclerosis (ALS) was admitted to the clinic to start non-invasive mechanical ventilation (NIMV) due to respiratory involvement. After 3 weeks from NIMV performed at night time, with beneficial effects, he suddenly complained of breathlessness even at rest and in standing position. Respiratory and cardiac assessments did not show new clinical events, indicating worsening respiratory function. Due to a history of osteoporosis which was treated with bisphosphonates, and even though no previous bone trauma or falls were reported, we performed a spine computed tomography scan.