Amyotrophic Lateral Sclerosis
(ALS; Lou Gehrig's Disease; Motor Neuron Disease)
|The Nervous System|
|Copyright © Nucleus Medical Media, Inc.|
- Having a family member with ALS
- Being in the military or having other occupations with risk of exposure
- Having certain genetic mutations
- Progressive weakness in arms and legs (at first often on only one side) over weeks to months without changes in sensory abilities.
- Initial presentation may be a wrist or foot drop
- Trouble holding things without dropping them
- Frequent tripping while walking
- Shrunken muscles
- Twitchy muscles
- Unpredictable changing emotions
- Overactive reflexes
- Slurred speech
- Trouble chewing and swallowing, resulting in frequent choking and gagging
- Weight loss due to trouble eating
- Trouble breathing
- Excess salivation, drooling
- Mental skills and abilities remain unchanged in most
- Sensation is intact
- Trouble coughing, resulting in development of pneumonia
- Electromyogram (EMG)/nerve conduction velocities (NCV)—To evaluate the muscles and the nerves
- Computed tomography (CT) Scan—A type of x-ray that uses a computer to make pictures of the structures inside the head and spine
- Magnetic Resonance Imaging (MRI) Scan—A test that uses magnetic waves to make pictures of the structures inside the head and spine
- Blood tests—To rule out metabolic, heavy metal exposure, or rarely infections (e.g., Lyme disease, HIV, human T-lymphotropic virus [HTLV])
- Lumbar puncture—A procedure to collect cerebrospinal fluid (CSF)
- Urine tests
- Taking medicines
- Working with therapists and joining a support group
- Participating in religious and social activities
- Diazepam (e.g., Valium), baclofen (e.g., Lioresal), or dantrolene—To reduce spasticity
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain medicines
- Atropine (e.g., AtroPen), scopolamine (e.g., Isopto), botulinum toxin (e.g., Botox), antihistamine—To reduce heavy drooling
- Antidepressants and anti-anxiety medicines
- A combination of dextromethorphan and quinidine—To treat inappropriate laughter or crying
Other Types of Treatments
- Physical therapy—To reduce pain associated with muscle cramping and spasticity.
- Respiratory care—In some cases, you may need to receive a mixture of air and oxygen from a machine. If you cannot move enough air in and out of your lungs, you may need surgery to have a tube inserted into your airway.
- Nutritional care—Your doctor may make changes to your diet. In some cases, getting nutrition through tube feeding is needed.
- Speech therapy—Speech therapy may be used to optimize communication. Therapy can include exploring alternative methods of communication.
ALS Association http://www.alsa.org/
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/
ALS Society of British Columbia http://www.alsbc.ca/
ALS Society of Canada http://www.als.ca/
Aggarwal, SP, Zinman L, Simpson E, et al. Clinical trial testing lithium in ALS terminates early for futility. Lancet Neurol. 2010; 9(5): 481-488.
Amyotrophic lateral sclerosis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/. Updated January 11, 2012. Accessed September 8, 2012.
Amyotrophic lateral sclerosis fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail%5Famyotrophiclateralsclerosis.htm. Accessed September 8, 2012.
Bradley WG, Daroff RB. Neurology In Clinical Practice. Philadelphia, PA: Butterworth Heinemann Publishing; 2004.
Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: The McGraw-Hill Companies; 2005.
Miller RG, Mitchell JD, Lyon M, et al. Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). The Cochrane Library. Chichester, England: John Wiley & Sons, Ltd; 2005.
Samuels MA, Feske SK. Office Practice of Neurology. Philadelphia, PA: Churchill Livingstone; 2003.
Sathasivam S. Managing patients with amyotrophic lateral sclerosis. Eur J Intern Med. 2009;24:355-358.
Walling AD. Amyotrophic lateral sclerosis: Lou Gehrig's disease. Am Fam Physician. 1999;59:1489-1496.
4/17/2008 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Fornai F, Longone P, Cafaro L, et al. Lithium delays progression of amyotrophic lateral sclerosis. Proc Natl Acad Sci USA. 2008;105:2052-2057.
1/14/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mateen FJ, Carone M, Sorenson EJ. Patients who survive 5 years or more with ALS in Olmsted County, 1925-2004. J Neurol Neurosurg Psychiatry. 2010;81(10):1144-1146.
- Reviewer: Rimas Lukas, MD
- Review Date: 10/2012 -
- Update Date: 10/11/2012 -