This week on the program, our earlier episode on the multidisciplinary care of ALS patients gets a face lift. Since it originally aired in 2016, there have been several important advances in the treatment of these patients--including the first FDA approved therapy for this condition in more than 2 decades. But many of the core management strategies remain the same. Dr. Lauren Elman, Associate Professor of Neurology, Director of Research Operations and Associate Director of clinical care at the Penn Comprehensive ALS Center, shares her experience in this 2019 update. Produced by James E. Siegler. Music courtesy of Chris Zabriskie, Nuno Adelaida, and Meydan. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES de Carvalho M, Dengler R, Eisen A, England JD, Kaji R, Kimura J, Mills K, Mitsumoto H, Nodera H, Shefner J and Swash M. Electrodiagnostic criteria for diagnosis of ALS. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 2008;119:497-503. Ludolph A, Drory V, Hardiman O, Nakano I, Ravits J, Robberecht W, Shefner J and ALS/MND WFNRGO. A revision of the El Escorial criteria - 2015. Amyotroph Lateral Scler Frontotemporal Degener. 2015;16:291-2. Geevasinga N, Loy CT, Menon P, de Carvalho M, Swash M, Schrooten M, Van Damme P, Gawel M, Sonoo M, Higashihara M, Noto Y, Kuwabara S, Kiernan MC, Macaskill P and Vucic S. Awaji criteria improves the diagnostic sensitivity in amyotrophic lateral sclerosis: A systematic review using individual patient data. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 2016;127:2684-91. Geevasinga N, Menon P, Scherman DB, Simon N, Yiannikas C, Henderson RD, Kiernan MC and Vucic S. Diagnostic criteria in amyotrophic lateral sclerosis: A multicenter prospective study. Neurology. 2016;87:684-90. Weiss MD, Macklin EA, Simmons Z, Knox AS, Greenblatt DJ, Atassi N, Graves M, Parziale N, Salameh JS, Quinn C, Brown RH, Jr., Distad JB, Trivedi J, Shefner JM, Barohn RJ, Pestronk A, Swenson A, Cudkowicz ME and Mexiletine ALSSG. A randomized trial of mexiletine in ALS: Safety and effects on muscle cramps and progression. Neurology. 2016;86:1474-81. Hardiman O and van den Berg LH. Edaravone: a new treatment for ALS on the horizon? The Lancet Neurology. 2017;16:490-491. Meininger V, Genge A, van den Berg LH, Robberecht W, Ludolph A, Chio A, Kim SH, Leigh PN, Kiernan MC, Shefner JM, Desnuelle C, Morrison KE, Petri S, Boswell D, Temple J, Mohindra R, Davies M, Bullman J, Rees P, Lavrov A and Group NOGS. Safety and efficacy of ozanezumab in patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled, phase 2 trial. The Lancet Neurology. 2017;16:208-216. Radunovic A, Annane D, Rafiq MK, Brassington R and Mustfa N. Mechanical ventilation for amyotrophic lateral sclerosis/motor neuron disease. The Cochrane database of systematic reviews. 2017;10:CD004427. Writing G and Edaravone ALSSG. Safety and efficacy of edaravone in well defined patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled trial. The Lancet Neurology. 2017;16:505-512. Oskarsson B, Moore D, Mozaffar T, Ravits J, Wiedau-Pazos M, Parziale N, Joyce NC, Mandeville R, Goyal N, Cudkowicz ME, Weiss M, Miller RG and McDonald CM. Mexiletine for muscle cramps in amyotrophic lateral sclerosis: A randomized, double-blind crossover trial. Muscle Nerve. 2018. Luo L, Song Z, Li X, Huiwang, Zeng Y, Qinwang, Meiqi and He J. Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis-a systematic review and meta-analysis. Neurological sciences : official j