Amyotrophic Lateral Sclerosis
(Lou Gehrig's Disease · ALS)
In this condition factsheet:
Diagnosing Amyotrophic Lateral Sclerosis
When the muscles get progressively weaker, especially if a person's sensations aren't at all impaired, doctors will suspect ALS. The standard criteria for establishing the diagnosis of ALS are:
- the presence of lower and upper motor neuron degeneration with documented progression of symptoms, either within the same body area or to other areas
- the absence of electrodiagnostic (EMG) or pathologic (biopsy) evidence of another disease processes that could cause lower and/or upper motor neuron degeneration
- the absence of neuroimaging (MRI) evidence of other disease processes that could explain the symptoms
A series of tests may be needed to rule out other potential causes for symptoms. Electromyography (EMG) is used to determine whether the problem is in the muscle or the nerve cells. This test works by measuring the electrical activity in the muscle.
A magnetic resonance imaging (MRI) scan of the head or spine may be used to exclude other conditions that can damage or compress nerve cells such as cervical spondylosis, multiple sclerosis, and thyroid disorders.
Based on where in the body symptoms first appeared, and where or how they progress over time, your doctor can tell the difference between ALS and other conditions.
Treating and Preventing Amyotrophic Lateral Sclerosis
Because the exact causes of the disease haven't been pinpointed, ALS cannot be prevented or cured. The treatment is focused on managing the symptoms and allowing the patient to have a good quality of life. Many health care specialists will be involved, including the family doctor, home nurses, a neurologist, respiratory therapist, physical therapists, occupational therapists, nutritionists, and social workers.
Medications are available, however, that may slow the progress of the disease and that deal with some of the symptoms.
Riluzole* is a medication that appears to prolong the life of some people with ALS by at least a few months. Riluzole seems to do 2 things: block sodium and calcium channels to decrease the effects of glutamate and increase its clearance.
Another medication, edaravone, has shown benefits in slowing the progression of ALS. This medication is an antioxidant and is believed to decrease oxidative stress, which is thought to be part of the process that kills neurons in people with ALS.
Muscle spasms – and sometimes cramps – can be controlled with the medications baclofen or diazepam. Medications can also be used to lower the amount of saliva that's made to help people who've lost the ability to swallow it.
To avoid choking or inhaling food and saliva into the lungs, a feeding tube might need to be placed into the stomach. People with difficulty breathing will eventually have to go on a respirator. Physical therapy can help people maintain strength in their muscles and control muscle contractions. Speech therapy can help people with speech and swallowing difficulties. Many will benefit from a motorized wheelchair and devices that allow communication through eye movements.
Although a person's physical state worsens, their mental capacity does not. To cope with the progression of the disease, good emotional support from family and friends is important. Support groups can also be helpful: the ALS Society of Canada can be contacted by phone (1-800-267-4257) or email (alscanada@als.ca), or accessed online at www.als.ca.
End-of-life care is an essential component of the care for someone with ALS. The person should choose how they wish to be treated in the late phase of the disease. This is usually done by filling advance directives.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Amyotrophic-Lateral-Sclerosis
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