In some neurodegenerative diseases, such as ALS, when the symptoms involve swallowing, the patient may show nutritional impairment, dehydration, misaspiration or even recurrent aspiration pneumonia. In this case, percutaneous gastrostomy treatment needs to be considered, with attention to the following aspects: 1. The patient’s own decisions are crucial and should be given sufficient respect and attention. The choice of treatment should be discussed in detail and should include the family, caregivers and therapists before serious communication difficulties arise. 3. PRG is undoubtedly most beneficial for patients who are willing to make choices before they “have to”. Possible benefits: 1) No longer need to struggle with water intake 2) Reduced risk of aspiration 3) Prevent further weight loss 4) Can be administered via PRG 5) Patients can still eat orally, if possible Possible risks: 1) PRG is an invasive procedure 2) Patients need to be hospitalized for a few days for observation 3) Possible intraoperative infection 4) Intraoperative and postoperative bleeding As patients vary, some may feel that PRG can improve their quality of life. Some patients feel that PRG can improve their quality of life, while others do not think it is worthwhile. The final choice is still up to the patient.