Amyotrophic lateral sclerosis and palliative care: Where we are, and the road ahead by Dr. Leslie J. Blackhall, interviewed by Dr. Michael K. Hehir. Patients with amyotrophic lateral sclerosis (ALS) have high symptom burdens, including pain, fatigue, dyspnea, and sialorrhea, and they must make difficult decisions about the use of life-prolonging therapies, such as long-term mechanical ventilation. The impact of ALS is also felt by family caregivers who often struggle to meet the heavy physical, financial, and emotional demands associated with the illness. Expert multidisciplinary care may improve both quality and length of life of patients with ALS. However, although advances have been made in the treatment of some symptoms, others, including pain management, remain poorly studied. Involvement of palliative care specialists as part of the ALS multidisciplinary team is recommended, as we continue to work toward improving the quality of life for patients and their families. Muscle Nerve, 2012. The ideas and opinions expressed are solely those of the specific authors and do not necessarily represent those of AANEM.