Amyotrophic Lateral Sclerosis

Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a kind of degenerative diseases involving motor neurons of the body.

ALS  also comes in the motor neuron diseases that selectively affects the motor neurons which controls the voluntary muscles of the body.

ALS  affects the central  nervous system of the body both brain and the spinal cord.

The nerves controlling the limb movements, speech and the swallowing are mainly affected.

ALS is also known as Lou Gehrig syndrome a famous baseball player was diagnosed with this diseases in 1939 for the first time.

There is no cure for the ALS only symptomatic treatment works on it.

Causes of the ALS

  • The exact cause is unknown it is sporadic.
  • Some of the estimation regarding the causes of the ALS are as follows-
      1. An immune response that directly damages the healthy neurons of the body.
      2. Imbalances in the chemical messengers at the neuromuscular junction.
      3. Abnormal building of the proteins in the nerve cells.
      4. Some of the chemical exposure such as lead, can leads to ALS causes.
  • ALS is more common in men then in women.
  • The onset of symptoms occurs around 50-60 years of age but may appears in early age. 
  • ALS affects all economic, social, and racial groups.

Symptoms of ALS

The symptoms depends on the affected area and the progressive loss of the motor neurons in the body and vary from person to person.

The symptoms of the brainstem are-
  • difficulty in swallowing
  • hoarseness 
  • slurred speech
  • excessive drooling
  • difficulty in breathing
  • emotional instability
  • loss of tongue control and tongue atrophy
Tracts that carries signals to the periphery from the brain are also made up of motor neurons also gives various symptoms-
  • muscle weakness
  • muscle twitching
  • limb control loss
  • difficulty in breathing if diaphragm or other respiratory muscles involved.
Cognitive impairment is also common in ALS as behavioral changes, emotional instability, loss of attention and loss of memory along with the time.
As the disease progress the severity of the symptoms increases.
Both the sides are affected along with the time bilateral weakness.

Some of other symptoms are -
  • Urinary tract infections are more common.
  • Bowel and bladder problems.
  • Sensations are also lost along with the severity of the disease.
  • Skin infections are more common along with the respiratory infections.
Activities of the daily living such as eating, cleaning, dressing, sitting disability becomes more common because of weakness in the hands and the arms.

Diagnosis of ALS

There is no specific test for the diagnosis of ALS but can be diagnosed on the basis of the symptoms.
Progressive loss of the muscle mass along with the neurological dysfunctions from weeks to the months and difficulty in doing, the ADLs (activities of daily living).

Some of the diagnostic tests are-
  1. NCV- Nerve conduction velocity for the nerve function testing.
  2. EMG- Electromyography for the muscle functions.
  3. MRI- Magnetic resonance imaging for the higher centers dysfunction in the brain and the spinal cord.
  4. Blood testing- for any kind of autoimmune dysfunction antibody antigen reactions.
  5. Genetic testing for the familial history.

Treatment of the ALS

As the disease progress the complication becomes more severe and person is unable to perform daily living activities.

Respiratory and digestion problems are more common.
Subcutaneous and skin are more infected and whole of the other parts of the body are more deteriorated along with time.

Chances of prognosis is very rare, person family support and the good rehabilitation increases the quality of the life.

Medications are also limited for the ALS treatment. Some of drugs such as Riluzole is only the drug approved for the treatment of ALS.

Non invasive ventilation (NIV) is the main treatment in the respiratory failure with difficulty in breathing.

Physical therapy and speech therapy can enhance the quality of the life by functional independence through aerobic training, strengthening and stretching exercises.

Speech therapy can assist the people with difficulty in speaking.

In case of digestive problem person is having problem in swallowing and chewing the food so feeding tube to be considered with liquid diet.

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