A nervous system condition that impacts nerve cells in the brain and spinal cord is known as Amyotrophic lateral sclerosis (ALS). People with this condition can experience a loss of muscle control that often worsens over time. ALS is also called Lou Gehrig’s disease. Although the exact cause of this disease is unknown, some of it is inherited.
Amyotrophic lateral sclerosis usually starts with muscle weakness and twitching in the arms or legs, swallowing problems, or slurred speech. Therefore, this sclerosis type negatively affects muscles responsible for moving, eating, and breathing. Unfortunately, there is no way to cure this condition, which can be fatal.
Symptoms
The symptoms are different among patients because it depends on the nerve cells that are affected, other health problems, and other factors. However, the primary symptom of ALS is muscle weakness that commonly worsens over time. Check below some symptoms of ALS:
- Walking problems that interact with the daily routine
- Tripping and falling
- Hand weakness or clumsiness
- Weakness can also happen in the legs, feet, or ankles
- Difficulty speaking or swallowing
- Muscle cramps in the shoulders, tongue, and arms
- Behavioral or thinking changes
- Crying, laughing, or yawning at an inappropriate time
While this condition begins in the hands, feet, or legs it can spread to other body parts. As more nerve cells die the weaker muscles become. As a result, you may experience problems with breathing, speaking, swallowing, and chewing.
Moreover, this condition is often painless either in the early or later stages and does not affect bladder control. The senses such as the ability to taste, smell, hear, and touch are not commonly impacted by this condition.
Causes
The nerve cells affected by this condition are known as motor neurons. These motor neurons are divided into 2 groups (upper motor neurons and lower motor neurons). The upper motor neurons extend from the brain to the spinal cord to muscles in the body. The lower motor neurons go from the spinal cord to all body muscles.
In people with this condition, motor neurons tend to deteriorate gradually, which leads to their death. Damaged motor neurons no longer send messages to the muscles, which causes loss of muscle function. Furthermore, healthcare professionals found a genetic cause in 10% of people with ALS. In any case, experts continue studying potential ALS causes.
Risk Factors
The following risk factors could increase your risk of developing amyotrophic lateral sclerosis. Examples include:
- Genetics – Approximately 10% of all diagnosed ALS cases are inherited. It means the mutated gene is passed from biological parents to biological children. In such cases, doctors call this condition hereditary ALS. Moreover, a 50% chance of getting the abnormal gene have children who have parents with hereditary ALS.
- Age – The risk of developing ALS increases in people over 75 years old. However, it commonly happens between 60 and the mid-80s.
- Sex – Males over 65 years old are more prone to get this condition compared to females but after 70 years old this difference disappears.
Check below also some environmental factors often associated with elevated risk of ALS:
- Military service – As per studies, those who have served in the military are at higher risk of developing ALS. While experts do not fully understand why military service triggers ALS they think exposure to some metals or chemicals, traumatic injuries, viral infections, or intense exertion could play a role.
- Environmental toxin exposure – Some studies suggest that exposure to lead or other chemical substances in the workplace or at home is linked with this disease.
- Smoking – Some evidence shows that females who smoke have an increased risk of this condition, especially after menopause.
Complications
The following ALS complications usually appear when the condition worsens. Examples include:
Trouble Breathing
Weakness of the muscles caused by this condition can cause breathing problems over time. Commonly, doctors recommend a device (such as a mask ventilator) that helps to breathe during nighttime. This device is similar to that used for people with sleep apnea.
However, people with an advanced form of ALS choose to have a tracheostomy. This procedure involves surgery that makes a hole in the front of the neck. Additionally, one of the most common causes of death in people with ALS is breathing failure. Furthermore, roughly 50% of people die within 14-18 months after diagnosis but there are people that can live 10 years or longer with this health condition.
Speaking Problems
Approximately all people with amyotrophic lateral sclerosis experience weakness of the muscles that form speech. In most cases, it begins with slower speech and occasional slurring of the words. Thereafter, speaking clearly becomes difficult.
Eating Problems
Those who suffer from ALS can also experience swallowing problems that cause malnutrition and dehydration. Moreover, an increased risk of getting foods, liquids, or saliva into the lungs leads to pneumonia have people with this condition. One way to ensure proper nutrition and hydration is a feeding tube.
Dementia
Certain problems with language and decision-making can happen in people with ALS. Moreover, some of them are diagnosed with a dementia type called frontotemporal dementia.
Diagnosis
It is difficult to diagnose this condition because it causes symptoms similar to other health conditions. In such cases, doctors perform different tests to exclude other diseases with similar symptoms. Check below some tests:
- Electromyogram (EMG) – This test involves a needle that helps to record the electrical activity of the muscles during rest and physical activity. Physicians usually perform this test to determine whether you have problems with muscles or nerves or not.
- Nerve conduction study – This is a study that helps to measure the ability of the nerves to send signals to the muscles. It helps to identify nerve damage.
- MRI – This test uses a powerful magnetic field to make detailed images of the brain and spinal cord. It is usually used to identify herniated disks, spinal cord tumors, and other health conditions.
- Blood and urine tests – Doctors can take a sample of blood and urine to check for increased levels of serum neurofilament light.
- Lumbar puncture (spinal tap) – This test involves the removal of a small amount of spinal fluid for laboratory testing. The spinal fluid frequently appears in people with ALS.
- Muscle biopsy – In such cases, doctors will remove a small sample of the affected muscle and send it to the laboratory. This test helps to determine muscle diseases.
- Nerve biopsy – This test is done usually if your doctor suspects you may have a nerve disease.
Treatment
While treatment cannot reverse the condition it may lessen the symptoms and slow down their progression and improve your quality of life. Check below some treatment options usually recommended by doctors:
Medicines
The following medicines are approved by the FDA for ALS treatment. Examples include:
- Riluzole – This is an oral medicine that can increase life expectancy by roughly 25% in people with ALS. However, it can provoke some adverse reactions including liver problems, gastrointestinal diseases, dizziness, and others. Thus, it is advised to check regularly with your doctor liver function.
- Edaravone – This medication is usually recommended by doctors to reduce the progression of the symptoms that interact with daily routine. It is usually administered intravenously. Bruising, headaches, and walking problems are the most common negative effects caused by this medicine.
Furthermore, doctors may also prescribe you some medications to lessen other symptoms caused by ALS. These include:
- Leg swelling
- A sudden urge to urinate
- Sleeping disturbances
- Depression
- Pain
- Excessive saliva
- Fatigue (extreme tiredness)
- Constipation
- Muscles spasms and cramps
Therapies
Check below some therapies usually advised by doctors to improve breathing, speaking, and moving. For example:
- Breathing care – This procedure involves mechanical ventilation that helps to maintain steady breathing at night. It is usually recommended for people with breathing problems. While some people choose tracheostomy, others may have a surgery called laryngectomy. It helps to prevent the food and liquids from entering the lungs.
- Physical therapy – It involves low-impact exercise that helps you to stay independent and reduce pain and walking problems. Moreover, regular exercise can help to prevent cardiovascular problems and improve muscle strength.
- Occupational therapy – This treatment option involves a therapist who helps to find ways to get independent nonetheless weak of the hand and arm. Moreover, an occupational therapist can recommend some equipment that will help you perform daily activities (including dressing, grooming, eating, and bathing) easier.
- Speech therapy – This therapist helps people learn techniques that improve speech making it more understandable.
- Nutritional support – Your doctors usually work with you and your family to ensure proper nutrition. They recommend foods that are easier to swallow. Sometimes, people choose a feeding tube when experience trouble swallowing.
- Psychological and social support – It involves a social worker who will help you with financial problems, insurance, and equipment.
Frequently Asked Questions
What are the potential complications of ALS?
Complications usually appear when the disease worsens. These include:
- Trouble breathing, swallowing, or speaking
- Dysphagia
- Leg swelling
- Eating problems
- Weight loss
- Hand clumsiness
- Depression
- Paralysis
- Muscle cramps
Talk with your healthcare professional if any of the previous complications occur.
What are the ALS stages?
- Symptom onset
- Diagnosis
- Independence
- Assisted independence
- Moderate then advanced loss of function
- Death
Discuss with a healthcare provider for more details.
Can amyotrophic lateral sclerosis be cured?
No, there is no way to cure the condition but with proper treatment, you can lessen the symptoms and improve your quality of life. However, researchers continue studies and promise new medications and treatments.
