Amyotrophic Lateral Sclerosis
Lou Gehrig's Disease
By Audrea Emmons
• Amyotrophic lateral sclerosis (ALS), often referred to as "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action
progressively affected, patients in the later stages of the disease may become totally paralyzed.
• To date, there is no one test or procedure to ultimately establish the diagnosis of ALS. It is through a clinical examination and series of diagnostic tests, often ruling out other diseases that mimic ALS.
• electrodiagnostic tests including electomyography (EMG) and nerve conduction velocity (NCV) • blood and urine studies including high resolution serum protein electrophoresis, thyroid and parathyroid hormone levels and 24-hour urine collection for heavy metals
x-rays, including magnetic resonance imaging (MRI)
myelogram of cervical spine
muscle and/or nerve biopsy
thorough neurological examination
Signs and Symptoms
• The onset of ALS may be so subtle that the symptoms are frequently •
muscle weakness in one or more of the following: hands, arms, legs or the muscles of speech, swallowing or breathing
twitching (fasciculation) and cramping of muscles, especially those in the hands and feet
impairment of the use of the arms and legs
"thick speech" and difficulty in projecting the voice
in more advanced stages, shortness of breath, difficulty in breathing and swallowing
There is no cure for ALS. Stem cells have emerged as a
major tool for research into the causes of ALS, and in the
search for new treatments. Stem cell transplantation is also being studied as a treatment, but it is not yet clear what
their therapeutic potential is. The field of stem cell research in ALS is progressing rapidly, and The ALS Association is
spearheading work on several critical fronts.
• riluzole has been approved for treatment and may slow progression of the disease. It is expensive, however, and appears modestly effective. Generally, treatment is designed to help control symptoms. • Medications prescribed include
Drugs such as baclofen or diazepam may help control spasticity. Gabapentin may be prescribed to help control pain.
Trihexyphenidyl or amitriptyline may help patients swallow saliva. Because choking is common as ALS progresses, patients may need a tube called a percutaneous endoscopic gastrostomy (PEG) tube or feeding tube to be placed into the stomach for feeding. A referral to an otolaryngologist — an ear, nose and throat specialist — may be recommended. • Physical therapy, rehabilitation, use of appliances such as braces or a wheelchair, and other treatments may help muscles work as well as possible and improve your general health. Those who develop difficulty speaking may benefit from speech therapy as well as speech synthesizers and computer-based communication systems.
Yay more Treatment Info
• ALS patients gradually lose the ability to function and
care for themselves. They may survive from two to 10
years after the onset of the disease, with about 20 percent
of ALS patients living more than five years after diagnosis. • They Longest ALS Patient is Scientist Stephen Hawking
who was diagnosed with ALS at the Age of 21. He is now
Assess motor strength; presence of spasticity of flaccidity. Assess for presence of contracture.
Assess gag, cough and swallowing reflexes, and chewing.
Assess patient’s ability to swallow liquids...
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