Amyotrophic Lateral Sclerosis (ALS)

By Refadoc, Posted on : Tuesday, 15 September 2015 - 10:46 am IST

Understanding The Disease Behind The ALS Ice Bucket Challenge

The ALS Ice Bucket Challenge is the most trending news all over social media. From celebrities to politicians to a common man, everyone is excited to take up the challenge and post their videos over the social media websites. But, in the middle of all this excitement, we are forgetting the real cause for this awareness campaign. It is to raise FUNDS for ALS and to donate to the cause, if we are unable to complete this challenge. But honestly, how many of us actually know anything about ALS? Frankly, I am sure there will only be a handful of you. So, let’s know more about the disease which triggered the world into a frenzy.

ALS stands for Amyotropic Lateral Sclerosis, a nervous disorder which is known to cause muscle weakness as well as affect the physical function in an affected person. It is also known as Lou Gehrig’s disease, after the name of the famous basketball player who was diagnosed with it. ALS is basically a motor neuron disease which causes the nerve cells to break down and die gradually. Muscle twitching and weakness in the limbs are one of the most common symptoms of the disease.

Causes of ALS

In ALS, the nerve cells lose the capacity to control the movements of the muscles of the body, which leads to the dying of the cells and weakening and wasting away of the muscles. In about 5 to 10% of the cases, the disease is caused due to genetic inheritance. In other known cases, the reason for the disease is not known.

However, according to researchers, some of the major causes for the disease are as follows:

Genetic Mutation: Due to the different genetic mutations ALS tends to be inherited from the parents to the offspring.

Chemical Imbalance: People who are suffering from ALS have a higher level of glutamate in their body as compared to their counterparts. Glutamate is known to be a chemical messengers present around the brain and the spinal cord. When the amount of glutamate rises, it tends to prove toxic for the nerve cells leading to their untimely death.

Protein Mishandling: Mishandling of the proteins in the nerve cells often leads to the accumulation of these proteins in an abnormal amount, leading to the death of the nerve cells, eventually.

Signs and Symptoms of ALS

The early signs and symptoms of ALS are as follows:

  • Difficulty in walking or doing the normal everyday activities.
  • Weakness in the legs, ankles and feet.
  • Clumsiness.
  • Slurring of speech
  • Cramps and twitching in the muscles of the arms, legs and shoulders.
  • Difficulty in maintaining a good posture

At the beginning, the disease begins with the limbs of the affected person and from there on spreads to the other parts of the body. With the progression of the disease, it affects even the normal functions such as breathing, swallowing, speaking, etc. However, the disease is not known to affect the bladder movements or the thinking patterns of the affected person.

Diagnosis of ALS

ALS is very difficult to diagnose as its symptoms are quite similar to other neurological diseases.

Some of the major tests for the diagnosis of ALS are as follows:

EMG: Electromyogram is done with the insertion of a needle electrode through the skin into the muscles of the affected person. This is done in order to evaluate the activity of the muscles during the phase of their contraction and relaxation. With the recognition of the abnormalities in the muscles with an EMG, the doctors can determine the condition which is responsible for the disease.

Muscle Biopsy: A muscular biopsy is done in order to rule out the possibility of a muscle disease. In this, a small portion of the muscle is removed and is sent to the laboratory for the analysis.

Spinal Tap: in this, a small sample of the spinal fluid is removed from the person for the analysis. The doctor inserts a small needle in between the vertebrae of the person in order to remove a small amount of cerebro-spinal fluid, which is later tested in the laboratory.

Blood and Urine Tests: in this, the samples of the blood and urine of the affected person are sent to the lab in order to rule out the possibility of other diseases.

MRI: A Magnetic Resonance Imaging is done with the help of the radio waves in order to print out a detailed image of the brain and spinal cord of the affected person. MRI’s are done in order to check the person for spinal cord tumors, disk problems as well as for other conditions which could be leading to the signs and symptoms.

Treatment of ALS

There is no known medication which can reverse the disease. Because ALS is known to affect the physical as well as mental health of the person, it is recommended to have doctors which are trained in many areas. Your doctors will be the appropriate people in order to determine the right treatment option for you. Some of the options for the treatment are as follows:

Medications: Rilutek is the sole medication which has been approved for the treatment of ALS. With the intake of this medication, the progression of the disease is known to slow down. This disease leads to the reduction in the levels of glutamate. However, some of the known side effects of the medication are dizziness, changes in the liver function as well as gastrointestinal problems.

Breathing Therapy: As the disease progresses, a person may be having difficulty breathing. Therefore, doctors may prescribe the person with mechanical ventilation in order to improve the breathing of the affected person.

Physical Therapy: Physical Therapy is done in order to work in addressing the pain that accompanies with the walking and overall mobility of the person. Some low impact exercises are done in order to work on the cardiovascular fitness of the person and to increase the strength of the muscular strength. With a regular exercise regimen, the person can control the pain and can increase the overall strength of his muscles.

Speech Therapy: Communication becomes a major problem with the progression of ALS. Therefore, a speech therapist is needed in order to help the person to take up the adaptive ways in order to make the speech better understood by others. Also, text to text applications are recommended in the later stages of the disease when it becomes very difficult for the person to even communicate the basics to the others.

Nutritional Support: In this, the team of doctors makes sure that the affected person is eating the food which is easier to swallow and therefore helps to meet with the nutritional demands of the disease and the body. Eventually, with the progression of the disease, a feeding tube is the only feasible option.

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