Overview of Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis (also known as ALS, motor neuron disease, and Lou Gehrig's disease) is a disease that affects the nervous system. This disease mainly causes muscle weakness and affects physical function. ALS causes motor neurons to slowly break down and die. This disease usually begins with occasional muscle twitching and weakness in the leg or arm. Another co-existing symptom can also be slurring of the speech.

As time passes by, the symptoms can get worse. Eventually, this disease can affect the ability to control the muscles that you need to breathe, eat, speak, and move. As of right now, there is no cure for this debilitating disease.Some early symptoms of ALS are:

  • Hand weakness and clumsiness

  • Slurring of the speech and trouble swallowing

  • Difficulty walking and doing normal activities, or tripping

  • Weakness in the knees, feet, and/or ankles

  • Difficulty holding up your head or keeping good posture

  • Muscle cramps or twitching of the arms, tongue, or shoulder

This disease usually starts in the limbs, hands, and feet. It then gradually spreads to other parts of the body, and the muscles become progressively weaker. This muscle weakness affects many daily functions such as swallowing, breathing, speaking, and chewing. Because ALS affects the motor neurons, there is no impact on one's ability to control the bladder and bowels, senses, and ability to think.

There are multiple possible causes of ALS such as gene mutation, a chemical imbalance of glutamate, protein mishandling, and disorganized immune response. There are some risk factors that increases the chances for developing ALS. Having a family member with ALS slightly increases the chances for ALS because about 5-10% of those with ALS inherited this disease.

Children of those with ALS have a 50% chance of developing this disease as well. Age and sex also plays a role in developing ALS. This disease found most in those who are between the ages of 40 and 60. Furthermore, in cases where ALS is diagnosed before the age of 65, men are more likely than women to be diagnosed. However, after the age of 70, this disparity disappears. There are also some environmental factors that can increase the risk for ALS such as lead exposure and smoking.

As ALS progresses, more complications will arise such as breathing problems, speaking problems, eating problems, and dementia. There are various diagnosis tests that can detect ALS. Many of these tests evaluates your muscle and nerve function such as an electromyogram (EMG), nerve conduction study, magnetic resonance imaging (MRI), muscle biopsy, or spinal tap.

Unfortunately, there is no cure for ALS; there are only ways to manage the symptoms of this disease. The only medication that is FDA approved that is effective for managing this disease is the drug riluzole (Rilutek).

This drug can slow down ALS' progression in some cases by decreasing the levels of glutamate in the brain. Many of those with ALS undergo various types of therapy to help manage this debilitating disease. Breathing care would be needed if you have difficulty breathing by yourself. Breathing therapy involves testing your breathing ability every so often and proving devices to assist with your breathing at night. In severe cases, a mechanical ventilator would be needed to assist with your breathing. Physical and occupational therapy would be needed to help maintain independence and manage the pain. Physical therapy will maintain cardiovascular fitness, range of motion, and muscle range. Occupational therapy will help you adjust to the change while maintaining your independence through assistive technology and adaptive equipment. These provide support for many daily activity such as bathing, eating, dressing, and grooming.

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