Amyotrophic lateral sclerosis or ALS is also referred to as 'Lou Gehrig's disease'. This is a neurodegenerative disease that attacks motor neurons (nerve cells that control voluntary muscles). The disease progresses rapidly. It weakens the muscles and affects the function of the muscles adversely. This is a type of motor neuron disease, which is invariably fatal. As motor neurons break down and gradually die, the brain loses control over voluntary muscles. However, the involuntary muscles continue to work. The patients can see, smell, taste, hear, think, and recognize touch. They usually have control over eye muscles and bladder and bowel functions. Statistics show that men are affected more often than women.
ALS Disease Causes
- The exact cause(s) of ALS disease remains unknown. Apart from some genetically predisposed conditions (gene mutations), there are certain conditions that can lead to the destruction of motor neurons.
- According to some experts, a viral infection may trigger motor neuron damage.
- A few experts suggest 'glutamate', a chemical messenger, as one of the factors for development of ALS. Elevated levels of glutamate around the nerve cells in the spinal fluid causes destruction of the cells.
- Free radicals in the body may also cause motor neuron death. In few people a gene that produces the enzyme superoxide dismutase, is abnormal. This enzyme is important for destruction of free radicals within the body. As the enzyme is abnormal, it cannot destroy free radicals which in turn destroy the motor neurons.
- A person's immune system may attack and destroy healthy nerve cells, leading to ALS.
- Glutamate is an amino acid found in all protein-containing foods. If the proteins in the cells are not processed properly, and if the abnormal forms of proteins accumulate in the nerve cells, they may bring about death of the nerve cells.
Symptoms of ALS Disease
In men as well as women, ALS disease causes gradual deterioration of the muscles of the body. Progression of ALS symptoms is different in different patients. At the onset of ALS, the symptoms are so unclear and subtle that they are frequently overlooked.
Early Symptoms of ALS
- The first symptoms of ALS in men and women may vary from person to person. The rate of progression of the disease also varies in each patient.
- The commonly observed early symptom is dysphagia. The patient finds it difficult to swallow food or liquid.
- The person experiences muscle weakness in hands, arms, or legs as well as problems in breathing.
- Due to damaged muscles, limited use of arms and legs is possible.
- One may have twitching muscles as well as muscle cramps, especially in the hands and feet.
- The gait becomes clumsy and more stiffer.
- The limbs become thinner due to muscle wastage.
- Loss of coordination and loss of strength in muscles are the main symptoms of ALS disease.
- The voice may become hoarse. There can be a change in the speech pattern of the person. He may find it difficult to project the voice.
- Uncontrollable periods of laughing or crying can be noticed.
- Tripping and falling frequently is one of the most common ALS symptoms in women and men.
Symptoms of Advanced ALS
- One may suffer from frequent episodes of shortness of breath.
- In the later stages, as the muscles become weak and paralyzed, the patient will not be able to use his arms and legs at all.
- He may find it difficult to hold his head up. He may not be able to keep a good posture.
- Eventually the patient will not be able to swallow, speak, chew, and breathe.
- The patient will need ventilator support for breathing, as the respiratory muscles become completely paralyzed.
ALS Disease Treatment
Usually, ALS patients die within 3 to 5 years from the onset of symptoms, mostly by respiratory paralysis or pneumonia. About 10% of these patients survive for 10 or more years. No treatments can alter the course of ALS disease. No medicine can reverse nerve damage or muscle weakness. Most of the ALS disease treatments focus on making the life of the patient easy. The first FDA approved drug Rilutec is said to help increase the life of the patient to some extent. It helps lower the glutamate levels. This helps slow down the worsening of the disease, and usually delays the need for a tracheostomy (breathing tube).
Other treatments for ALS disease involve physiotherapy, exercises, and medication that help make the patient feel comfortable. Braces may be suggested to patients to help them walk, and support themselves while standing. Those who have lost the ability to swallow are fitted with a feeding tube. Gastrostomy is also suggested to patients who are suffering from recurrent pneumonia, rapid weight loss, etc. Respiratory decline is treated with the help of non-invasive ventilation like BiPAP, tracheostomy, or ventilator.
About 5 to 10 % of all ALS cases are inherited. Researches are being conducted to understand the mechanisms that selectively bring about degeneration and death of motor neurons, and also to find effective measures to halt these processes.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.