Amyotrophic Lateral Sclerosis (ALS) is a nervous system disorder that causes a loss of muscle control that progresses over time. This is due to effects on the nerve cells in the brain and the spinal cord. This condition is sometimes also called Lou Gehrig’s Disease, after the baseball player who was first diagnosed with it. The exact cause of this condition is not well understood, and complications of ALS are common.
Most patients start to show mild symptoms related to ALS that can be misdiagnosed as other conditions. These symptoms can show up early in life but are more typically expressed near the end of adolescence into early adulthood.
The most common early symptoms are not associated with pain. Muscle twitching in an arm or a leg or trouble swallowing, and slurred speech are common early symptoms. Other symptoms include:
The extremities, like the arms and legs, are most often affected first. As more nervous tissue is impacted, the condition tends to spread into other body systems. Bladder control and the senses like touch, sight, hearing, and sense of smell are not usually impacted either. There is no cure for this condition, and it is always fatal to patients.
The exact cause of ALS is not well understood. It is clear that nervous cell and tissue damage is the reason for the loss of function that patients develop as the disease progresses. ALS impacts both the spinal cord and upper motor neurons to slowly fail and die. This leads to increasing weakness, loss of muscle control, and over time, paralysis.
The risk factors for ALS are:
ALS can be tough to diagnose in the early stages because the symptoms might be episodic or so mild that they do not appear to be linked to ALS. When symptoms begin to progress, and ALS is suspected, there are some diagnostic methods that can be used to get a clear answer.
An electromyogram (EMG) can be used to test the electrical activity in the affected muscles. Nerve conduction studies can also measure the nerve impulses that are being sent throughout the body. MRI can also be used to look at the condition of the spine or the neck to see if there are other reasons for the symptoms that a patient is experiencing.
Blood and urine tests and spinal taps can also help provide some answers and rule out other conditions with similar symptoms. In some cases, nerve biopsy and muscle biopsy can also be instructive.
Treatment of this condition cannot reverse the damage that has been done, but it can help to slow down some of the effects of the disease. A team of specialists will typically work on these cases, which means that a primary care doctor, a physical therapist, a speech therapist, and other care providers will need to help take care of the specific needs of ALS patients.
There are three medications that have been shown to help ALS patients. Riluzole increases life expectancy by about 25% in these patients, and Radicava can help control the decline of control over the muscles that impact daily functions. Relyviro can also help to slow the decline of motor functions by about 25% in ALS patients.
Other medications might be given to help control symptoms like muscle cramps, constipation, fatigue, excessive saliva and phlegm, pain, and depression. Sleep problems can also often be controlled with medications, and diuretics can help with swelling in the body.
Prevention of this condition is not usually possible. However, if you are a smoker, you should quit smoking. For those with a family history of ALS, genetic testing can be helpful to try and identify potential risk factors for the condition. Make sure that you have any symptoms of loss of function in your body parts looked at carefully if you have family members with this condition.