Amyotrophic Lateral Sclerosis (ALS) Amyotrophic Lateral Sclerosis (ALS) has traditionally been described as a disease that manifests as atrophy and progressive weakness of the skeletal, spinal, and bulb muscles due to the degeneration of motor neurons in the anterior medulla horn. and of the corticoespinal system. Sensitive function is generally maintained. It is accompanied by impaired speech (dysarthria) and difficulty swallowing. Emotional lability is also common. As with other progressive neurological diseases, its etiology is still unknown, although it is attributed to a possible viral, toxic, genetic or endocrine cause. Currently there are no effective drugs that can act during the course of the disease, but there are no drugs that can alleviate the symptoms. However, rehabilitation, with the participation of different professionals and from the earliest stages of the disease, improves the quality of life of these patients. In more advanced cases, the use of a pacemaker surgically implanted in the diaphragm causes muscle contraction and offers patients with some neuromuscular diseases, such as ALS, dependent on continuous mechanical ventilatory support, the ability to breathe. without mechanical support (after proper training). This represents a significant improvement in their quality of life, a reduction in recurrent respiratory infections and, ultimately, an increase in survival. The Guttmann Institute is a pioneer in the implantation of this type of pacemaker in our country, both in adults and children of very young age (in the latter case, due to high cervical spinal cord injuries), with highly satisfactory results.