Amyotrophic lateral sclerosis is neurological problem that causes impairment in physical movement and muscular weakness. The affected person may not be able to move or speak as before and is a nervous system disorder. The nerve cells of the spine and the brain will gradually become weak and ultimately die. It is not clear what causes ALS and the disease cannot be cured but the symptoms can be treated. ALS is also known as Lou Gehrig’s disease since it was first diagnosed with the famous football player. When the neurons progressively become weak and unable to function properly the person’s voluntary muscular movement will become paralyzed.
Symptoms :
Initial symptoms of ALS include difficulty in talking, walking and carrying out routine activities. There will be weakness in the legs and ankles causing great difficulty in moving his legs. The affected person will make clumsy movements due to his inability to move the muscles properly. It may cause difficulty in eating and talking. He may not be able to stand or sit in good posture and cannot make any muscular movements on his legs and hands as before.
The paralyzed muscular movement will gradually spread to various parts of his body after his hands and limbs are affected. The person will have great trouble in speaking and even breathing. As more and more of motor neurons die due to the progression of the disease the person will eventually become paralyzed and even die. Fortunately the nerves that are involved in digestion and bladder control are not affected by ALS since they are done automatically.
Causes :
The disease of ALS can be genetic suggesting that it can be inherited. It is the nerve cells that are actually affected in this disease causing progressive weakness. Although there is no solid theory that explains what causes ALS there are theories suggesting that it can occur due to gene mutation or chemical imbalance. An individual affected with ALS will have high levels of glutamate which is a chemical secreted in the brain leading to toxicity. Weakened immunity can also trigger ALS leading to nervous disorder.
Who are at risk?
Children born to parents of ALS have increased chance of developing this disease. Men are more prone to have this disorder than women and often the disease occurs in the age group of 40-65. A person who is smoking continuously and a person who have increased exposure to poisonous chemicals like lead have increased risk for getting ALS.
Consequences :
As the disease progresses it may affect your normal functions like eating, breathing and speaking. Certain muscles involved with breathing can get affected and paralyzed leading to difficulty in breathing. In the advanced stage of ALS the patient will have to depend on tracheostomy procedure that involves artificial respiration. In many causes the patients with advanced stage of ALS will die due to lung failure.
ALS can affect the normal speaking ability of the person causing slurred speech. For some people the speech can become totally affected as the disease progresses. The neuro-generative disease can affect the eating or swallowing ability of the person leading to malnutrition. In rare cases ALS can cause dementia.
Tests :
Some of the symptoms of ALS are very much like other neurological problems and hence it is difficult to be diagnosed at early stage. After examining the patient and collecting his medical history, the doctor may request for electromyogram for studying the electrical activity of the muscles. Abnormal muscular activity can be due to ALS or nerve cell death.
Nerve conduction study is administered to assess the ability of the nerves to send or receive impulses. In some cases imaging tests like CT or MRI scan is done for getting clear images of the brain function. Lumbar puncture is also done in some people to collect the spinal fluid for testing. If necessary, the doctor may do muscle biopsy for testing in the laboratory.
Treatment :
There is not a single medication or therapy to treat ALS but the symptoms can be controlled or slowed down to prevent many complications. The symptoms of one person may vary squarely with other person and hence the method of treatment is devised suitably suiting the needs of the person. Riluzole is prescribed for ALS to slow down the progression of the disease. It can cause slight dizziness or GI problems in some people.
Medications are given for controlling the symptoms of muscular cramps, fatigue and spasticity. Suitable drugs are given to reduce sleep apnea and other sleep related problems. For people with severe breathing difficulty, mechanical ventilation is given by tracheostomy procedure in which a small tube is inserted in the neck portion to connect with windpipe which is then connected to respiratory machine. Physiotherapy is given for reducing problems in muscular movement in walking. Suitable exercises are suggested for improving the muscular strength and for getting cardiovascular fitness.
The affected person will be taught the ways of using walker or wheelchair or tramps to improve one’s walking ability. Suitable stretching exercises will help in getting relief from muscular cramps or pain. Hand or arm weakness can be treated with suitable occupational therapy so that the affected person can carry out his daily activities. A speech therapist can help you to overcome your speaking ability and to get improved communication. Nowadays tablet computers are used for effective methods of communicating. The affected person should make sure that he/she gets adequate nutrition if they have problems in eating or drinking.
Coping with Problems :
It is hard to accept that you have serious neurological problem like ALS but you have to overcome the shock and grief and develop positive ideas to carry on with your life. Joining a support group can help you in sharing your feelings with others who are undergoing similar pain and physical problems. Discuss with your doctor about the ways of improving the quality of life with suitable therapy.