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Home > Blog > Neurology > Amyotrophic Lateral Sclerosis: Symptoms & Treatment
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Amyotrophic Lateral Sclerosis: Symptoms & Treatment

by Narayana Health December 29, 2020
written by Narayana Health December 29, 2020
Amyotrophic Lateral Sclerosis

Amyotrophic Lateral Sclerosis, also known as ALS, is a degenerative nervous system disease that affects the brain’s nerve cells and the spinal cord, which causes the patient to lose muscle control. ALS is commonly known as Lou Gehrig’s disease; Lou Gerig was the baseball player diagnosed with this disorder. There are no fixed Amyotrophic Lateral Sclerosis causes, doctors believe that it can be a genetic disease (in some cases). Amyotrophic Lateral Sclerosis (ALS) starts with random muscle twitching and weakness in limbs, along with slurring of speech. Gradually, the patient will lose control of all motor functions like speaking, eating, moving, and breathing. There is no cure for the Amyotrophic Lateral Sclerosis disease.

Who Gets ALS?

Amyotrophic Lateral Sclerosis (ALS) is a common neuromuscular disease, which affects all people of various races and ethnicities. Some of the common Amyotrophic Lateral Sclerosis symptoms can show up in people, based on the following:

  • Age: Even though the disease can occur at any age, the symptoms start surfacing between the ages of 55 and 70.
  • Gender: Men are slightly more prone to ALS than women.
  • Ethnicity and race: Caucasians and Non-Hispanics are more likely to develop the Amyotrophic Lateral Sclerosis disease.

Sporadic ALS

Almost ninety percent of ALS cases are sporadic. This means that the Amyotrophic Lateral Sclerosis symptoms will start showing up randomly, even if you have no family history of the disease or are not associated with any risk factors.

Is Amyotrophic Lateral Sclerosis Genetic?

Around five to ten percent of all ALS cases are familial, this means the patient gets the disease from their parents. Genetic ALS requires only one parent to carry the gene responsible for the disease.

Amyotrophic Lateral Sclerosis Symptoms

ALS is subtle, which means, in the beginning, the symptoms can be overlooked. However, as time goes by, these symptoms will develop and get intense; they will eventually lead to weakness and atrophy, this is where a doctor will diagnose it as Amyotrophic Lateral Sclerosis. Some of the early symptoms you have to look out for are:

  • Muscle twitches in the arm, shoulder, leg, or tongue
  • Muscle cramps
  • Stiff muscles
  • Nasal and slurred speech
  • Difficulty in swallowing and chewing

Many patients will first start seeing the ALS signs in their hands, they will start having difficulty conducting simple tasks like buttoning shirts, writing, turning a key in a lock, and so on. Some patients may start noticing weakness in their legs, they will experience difficulty walking or running; it will seem like they are stumbling or tripping more than normal.

When the Amyotrophic Lateral Sclerosis (ALS) signs start showing up in legs or arms, it’s known as limb onset. In some cases, the patients will start noticing swallowing or speech problems, these signs are known as ‘bulbar onset’.  Nonetheless, wherever the disease starts, it will start progressing all over the body, over time. Patients will start experiencing difficulty with speaking, moving, swallowing, and breathing.

The rate of ALS progression will vary for each person, eventually, the patient won’t be able to walk, get out of bed, or use their hands and arms. Due to these Amyotrophic Lateral Sclerosis symptoms, the patient will start losing weight, rapidly, and they can become malnourished.

Once ALS intensifies, the patients will experience difficulty breathing because the respiratory muscles get quite weak. They will lose the ability to breathe on their own and will have to depend on a ventilator. The affected patients will face a risk of contracting pneumonia in the later stages of the disease. Muscle cramps can cause huge discomfort and some Amyotrophic Lateral Sclerosis (ALS) patients can develop painful nerve damage.

Amyotrophic Lateral Sclerosis Causes

There is no certain cause behind ALS, scientists have yet to find out why the disease strikes some people and not others. Studies suggest that a combination of genetics and external environment elements play a role in ALS development.

Genetics

The unraveling and discovery of various genetic mutations that lead to ALS suggest that the change in RNA molecules can lead to ALS-related neuron degeneration that affects the patients’ motor functions. In the end, it’s made clear that many cellular defects can lead to neuron degeneration that causes Amyotrophic Lateral Sclerosis (ALS).

Environmental Elements

Studies have shown that the impact of environmental factors like exposure to toxic agents, viruses, physical trauma, diet, and occupational components can be the cause behind ALS. For instance, research suggests that exposure to toxic elements or intense physical activity can be reasons why veterans or athletes are at risk of developing ALS.

Although genetics and environmental elements are not consistently the cause behind ALS, studies have shown that they are contributors toward the development of the disease.

Amyotrophic Lateral Sclerosis Diagnosis

ALS cannot be diagnosed with just one test. The initial diagnosis is based on the history of various symptoms and signs that are observed by a doctor during physical examination. A series of tests are done to rule out any other similar diseases. The presence of lower and upper motor neuron symptoms will indicate the presence of Amyotrophic Lateral Sclerosis.

Doctors will go through the person’s entire medical history and conduct a neurologic exam during regular intervals so that they can assess the symptoms like muscle weakness, muscle atrophy, or stiffness, which get worse over time. The early symptoms of ALS can be quite similar to many diseases, which may be treatable disorders. Conducting the right tests can erase the possibility of other conditions. Some of the common tests conducted to diagnose ALS are:

  • Muscle and imaging tests
  • Tests for other disorders
  • Laboratory tests

Treatment of Amyotrophic Lateral Sclerosis

There is no definitive cure for Amyotrophic Lateral Sclerosis (ALS), but there are treatment plans which can control the symptoms, prevent complications, and make it easy to live with the disease.

Patients with ALS may need multidisciplinary health care teams that include medical professionals like physicians, pharmacists, speech therapists, clinical psychologists, and so on. This team will help the patient by developing a treatment plan that will keep them as comfortable and independent, as possible.

Dr. Aravinda RV | Associate Consultant Neurologist |  Narayana Multispeciality Hospital, Mysore

Amyotrophic Lateral SclerosisAmyotrophic Lateral Sclerosis ALSAmyotrophic Lateral Sclerosis ICD 10Amyotrophic Lateral Sclerosis symptomswhat Amyotrophic Lateral Sclerosis
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