Amyotrophic Lateral Sclerosis (ALS): Symptoms, Diagnosis & Treatment -

Amyotrophic Lateral Sclerosis (ALS): Symptoms, Diagnosis & Treatment

Author: Jonathan Pham
Review Date: 28/06/2019 | Last Modified: 25/09/2019
Amyotrophic Lateral Sclerosis (ALS): Symptoms, Diagnosis & Treatment

Overview

What is Amyotrophic Lateral Sclerosis (ALS)?

Amyotrophic Lateral Sclerosis (ALS) is a nervous system disease in which neurons in the brain and spinal cord gradually die. Initially, patients will experience muscle-related problems, which eventually causes disability. At the final stage, the respiratory system stops working, resulting in death.

ALS is also called Lou Gehrig’s disease, which is named after the baseball player that has died of the condition.

Who is at risk of ALS?

Up to now, this is not a common health condition. Men are more likely to get affected than women. The disease can occur at any age; however, it is mostly found at people who are 40-60 years old.

Symptoms

What are the common symptoms of ALS?

Patients who suffer from ALS are likely to experience weakness in the arm, leg and muscle twitching. Muscle weakness gradually spreads to both hands, feet and other parts of the body. As it advances to the spine and neck, patients will have difficulty in holding their heads up. At the final stage, people may experience motor paralysis, which causes difficulty in speaking, eating (swallowing) and breathing.

On the other hand, ALS does not affect patients’ senses of sight, smell, taste, hearing, and touch. However, they may suffer from mental problems such as slurred speech.

When to contact a doctor

You need to go to the hospital or contact a doctor as soon as you exhibit the following symptoms:

  • Difficulty walking and performing your daily activities.
  • Weakness/ numbness in the legs, feet, and knees
  • Hand weakness/ necrosis.
  • Stuttering or difficulty swallowing.
  • Numbness and twitching in the hands, shoulders, and tongue.
  • Difficulty raising your head, walking or sitting properly.

Causes

What causes ALS?

Currently, the exact causes of ALS still remain unclear. Worldwide, about 90% of patients diagnosed with the condition are reported to get affected randomly, and 10% have a family history of ALS.

It is also worth to note that ALS is not a contagious disease.

Risk factors

What factors increase the risk of ALS?

Various factors may increase the risk of ALS, including:

  • Genetics.
  • Environmental factors.
  • Smoking: smokers are twice as likely to get affected as those who do not.
  • Exposure to metals or chemicals.
  • Trauma due to falls, strong tremors.
  • Viral infection.
  • Intense physical exercise.

Diagnosis & Treatment

Diagnosis

The diagnosis of ALS is performed based on the patient’s medical history in combination with nerve and muscle tests. In these tests, the doctor will check the patient’s ability to walk, breathe, digest and react.

In addition, the doctor may also request electromyography (EMG) and a neurotransmitter survey. The purpose of these procedures is to measure the nerve and muscle’s function.

Other tests include genetic testing, computerized tomography (CT), magnetic resonance imaging (MRI), blood and urine tests, spinal cord and muscle biopsy.

Treatment

The aim of ALS treatment is to control the symptoms and prolong life as much as possible.

Patients can use Riluzole to prolong life and slow the disease’s progression. However, this method is not recommended due to the medication’s limited effect. Other medications may help control symptoms such as spasticity, digestive problems, abdominal pain, constipation, and depression. If the condition gets worse, you will need a gastric tube for eating. Nutrition experts play a critical role in balancing nutrition and limiting the disease’s progression.

On the other hand, physiotherapy and other psychological treatments can aid in the treatment process. During the later stages, the main goal is to help patients feel comfortable in their daily activities. In addition, some devices such as walkers, wheelchairs, and breathing machines may also make life easier for patients.

Finally, Stem cell treatment may promote the healing of brain injury and restore neurological function.

Prevention

What can I do to limit the progression of ALS?

To limit the risk and progression of ALS, you should practice the following habits:

  • Contact your doctor regularly for better monitoring of your symptoms and health status.
  • Always follow the doctor’s instructions. Do not take unspecified medication or stop taking medication at all.
  • Collect information about ALS and how to deal with the disease.
  • Join a health support group to help yourself and other patients.

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Miller RG, et al. Practice parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2009. http://www.neurology.org/content/73/15/1218.short. Accessed on June 28, 2019

Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed on June 28, 2019

Why is exercise important? In: Everyday Life With ALS: A Practical Guide. Muscular Dystrophy Association. http://www.als-mda.org/publications/everydaylifeals/ch8/. Accessed on June 28, 2019

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