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Amyotrophic Lateral Sclerosis (ALS)

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Amyotrophic Lateral Sclerosis

Amyotrophic Lateral Sclerosis (ALS) is a disease that destroys nerve cells and causes disability. The nerve cells gradually break down and die. Muscle twitching, weakness in a limb, or slurred speech is how ALS typically starts. It eventually affects the muscles needed to move, speak, and breath.The disease is progressive, and currently there is no cure for ALS. It belongs to a larger group of disorders known as motor neuron diseases, which are caused by gradual deterioration and death of motor neurons. In ALS, both the upper motor neurons and the lower motor neurons degenerate or die, and stop sending messages to the muscles. Most people with ALS die from respiratory failure, usually within 3 to 5 years from when the symptoms first appear.

The majority of ALS cases are considered sporadic, which means the disease seems to occur at random with no clearly associated risk factors and no family history of the disease. Whereas around 5 to 10 percent of ALS cases are familial, which means that an individual inherits the disease from his or her parents.

Signs and symptoms include: difficulty walking or doing ADLs; tripping and falling; weakness in the leg, feet, or ankles; hand weakness or clumsiness; slurred speech or trouble swallowing; muscle cramps and twitching in the arms, shoulders, and tongue; difficulty holding the head up or keeping good posture. ALS most often begins in the hands, feet, or limbs, and later spreads to other parts of the body. Muscles will progressively weaken as the disease advances. ALS doesn’t typically affect senses, thinking ability, or bowel or bladder control. In some ALS cases the disease is inherited, while the others remain with no known cause. Researchers are also looking into gene mutation, chemical imbalances, disorganized immune responses, and protein mishandling. Research is also being done into cellular defects, stem cells, family versus sporadic ALS, biomarkers, and new treatment options.Various risk factors include heredity, age, sex, and genetics. Environmental factors that may trigger or affect risk of ALS include smoking, environmental toxin exposure, and military service.

Complications that people with ALS may experience include breathing problems, speaking problems, eating problems, and dementia. Amyotrophic lateral sclerosis can be hard to diagnose early on because it mimics many other neurological diseases. Tests to rule out other conditions may include electromyogram (EMG), nerve conduction study, magnetic resonance imaging (MRI), blood and urine tests, spinal tap, or muscle biopsy.

Treatment for ALS can slow the progression of symptoms, prevent complications, and make a person more comfortable. Two medications are currently approved for the treatment of ALS, Riluzole (Rilutek) and Edaravone (Radicava). A doctor may also prescribe medications to provide relief from symptoms including muscle cramps and spasms, spasticity, constipation, fatigue, excessive salivation, excessive phlegm, pain, depression, sleep problems, and uncontrolled outbursts of laughing or crying. Some therapies that people with ALS can do include breathing care, physical therapy, occupational therapy, speech therapy, nutritional support, psychological and social support.

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