Do you treat patients with riluzole who have ALS and a valosin-containing protein mutation?  

Yes. Riluzole is a glutamate antagonist; motor neuron damage due to glutamate-related excitotoxicity is a theme in ALS pathophysiology regardless of the genetic mutation that may cause ALS. Based on this, and the lack of any available VCP-specific treatments, I see no reason not to offer riluzole in...