Amyotrophic Lateral Sclerosis (ALS)

What is amyotrophic lateral sclerosis?

Amyotrophic lateral sclerosis (ALS) (also known as Lou Gehrig's disease or motor neuron disease) is a rare disorder in which certain nerve cells, located within the spinal cord and brain and which control muscle movement, are destroyed. The destruction of these nerves causes progressive muscle weakness and eventually leads to paralysis. The cause of ALS is not known. Early symptoms include tingling or weakness in arms or legs, muscle cramping and sometimes changes to the voice. There is no treatment to cure ALS, though there are some medications that will slow down the destruction of the nerve cells. Management of this condition aims to relieve the symptoms of ALS and support the person and their family. Most people with ALS will eventually die as a result of this condition, though there are famous examples of people living with ALS, such as the physicist Stephen Hawking.

Risks

There are no known causes or risk factors for developing ALS. Genes may play a small role, as 5 percent of people with ALS have a family member with the condition. However, people with ALS will not necessarily pass the condition to their children. The condition usually appears between the ages of 50 and 70, and men are slightly more commonly affected than women.

Symptoms

Early symptoms of ALS can be different from person to person, and include weakness and tingling in the arms and legs, muscle cramps and stiffness and sometimes voice changes or difficulty swallowing. People with ALS may find that they have difficulty controlling their emotions. As the condition progresses, the muscles become stiff and smaller, and people with ALS eventually lose their ability to move independently, to talk and to swallow and breathe.

Diagnosis

Diagnosis is made by evaluating the symptoms, and undergoing a physical examination by a neurologist. There is no single diagnostic test for ALS. However, several tests may be used to rule out other possible causes of the symptoms. These include blood tests, scans (usually an MRI), nerve testing, investigating the fluid around the spinal cord (lumbar puncture) and, in rare cases, muscle biopsy.

Treatment

There is no cure for ALS. There is a medication which can slow the progression of the disease, but the benefit of this can be different from person to person, and should be discussed with a neurologist. The management of ALS requires therapists from multiple areas to help maintain ability for as long as possible and to support a person physically, socially and emotionally. Eventually, breathing and eating can be replaced with feeding tubes or machines, but this is guided by individual beliefs and preferences.

Other names for amyotrophic lateral sclerosis

  • Lou Gehrig's disease
  • ALS
  • Charcot's disease
  • motor neuron disease
  • MND