Amyotrophic lateral sclerosis (ALS) is a progressive nervous system disorder. It gradually destroys the nerves responsible for muscle movement. Over time, ALS leads to total paralysis of muscle movement, including respiration.
Causes
The cause of ALS is not known, but it appears that genes may play a role in a very small number of cases.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Symptoms
Symptoms include:
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Progressive weakness in arms and legs (at first often on only one side)
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Trouble holding things without dropping them
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Frequent tripping while walking
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Shrunken muscles
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Twitchy muscles
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Overactive reflexes
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Slurred speech
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Hoarseness
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Trouble chewing and swallowing, resulting in frequent choking and gagging
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Weight loss due to trouble eating
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Trouble breathing
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Excess salivation, drooling
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Trouble coughing, resulting in development of pneumonia
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. There are no tests that definitively diagnose ALS, but tests may be used to rule out other medical conditions.
Tests may include:
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Electromyogram (EMG) – to look for progressive muscle weakness and twitching
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CT Scan - a type of x-ray that uses a computer to make pictures of the structures inside the head
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MRI Scan - a test that uses magnetic waves to make pictures of the structures inside the head
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Blood Tests
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Urine Tests
Treatment
There are currently no cures for ALS. The drug riluzole has been approved for ALS with a clinical trial revealing a modest lengthening of survival. It may slightly improve functioning for ALS patients, although it doesn't stop the disease progression. Other drugs are also being studied.
Treatments for the symptoms of ALS include:
Valium, Baclofen, or Dantrolene - to reduce spasticity
Nonsteroidal anti-inflammatory drugs (such as ibuprofen) and other pain medications - to reduce pain from muscle cramping
Physical Therapy – to reduce pain associated with muscle cramping and spasticity
Atropine, Scopolamine, or an Antihistamine – to reduce heavy drooling
Antidepressants, Anxiolytic Drugs, and Psychotherapy – to treat depression and anxiety
Prevention
There are no guidelines for preventing ALS because the cause is not known.
RESOURCES:
ALS Association
http://www.alsa.org
American Academy of Neurology
http://www.aan.com
References:
Amyotrophic Lateral Sclerosis: Lou Gehrig's Disease. Am Fam Physician. 1999 Mar 15.
Goetz CG. Textbook of Clinical Neurology, 1st ed. Philadelphia, PA: W. B. Saunders Company; 1999.
Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine, 16th ed. New York, NY: The McGraw-Hill Companies; 2005.
Miller RG, Mitchell JD, Lyon M, et al. Riluzole for amyotrophic lateral sclerosis (ALS) / motor neuron disease (MND). The Cochrane Library, Issue 3. Chichester, UK: John Wiley & Sons, Ltd.; 2005.
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/. Accessed October 12, 2005.
