Prise en charge nutritionnelle d’une patiente âgée obèse atteinte de sclérose latérale primitive

A patient in a nursing home suffered from primary lateral sclerosis (PLS), which is a slowly progressive neuromuscular disease, in her case, very disabling. She gradually developed obesity. The possibility of an underlying sarcopenia was eliminated, and the weight gain was explained by very low physical activity and especially uncontrolled snacking. In the absence of treatment for PLS, the patient was considered to be in a palliative situation. Invoking respect for her quality of life, she refused to moderate her snacking. The only recourse was to provide dietary advice to the patient, the teams and her family. This clinical case highlights the difficulty of nutritional assessment and management of people with neurological and neuromuscular diseases.