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ALS (Amyotrophic Lateral Sclerosis)

Amyotrophic Lateral Sclerosis

What is amyotrophic lateral sclerosis? — Amyotrophic lateral sclerosis (ALS) is a disease that damages the nerves that control muscles. This causes the muscles to weaken. The muscles slowly stop working, leaving the person unable to move (called "paralysis"). Over time, the disease gets worse and leads to death. ALS is also known as "Lou Gehrig's disease," after the famous baseball player who died of the disease.
Most people who get ALS live only a few years after their symptoms begin. There is no cure for ALS, but doctors can treat the symptoms.
What are the symptoms of ALS? — The main symptoms include:
Weak arm or leg muscles, usually starting in one arm or leg and later spreading to other parts of the body
Trouble speaking or swallowing
Slow, stiff, or awkward movements
Muscle twitches and spasms
If a person gets weak muscles in the hands or arms, he or she might have problems with:
Using buttons or zippers
Handling coins or other small things
If a person gets weak muscles in the legs or feet, he or she might have problems with:
Walking and turning
Climbing stairs
Standing up from a chair or the floor
If these symptoms happen, the person might have other problems, such as:
Feeling like the legs are "heavy"
Dragging the front of the foot on the ground when walking
Tripping or falling
If a person gets weak muscles in the head, neck, or chest, he or she might:
Have a stiff jaw and a hard time opening the mouth
Have trouble swallowing
Have trouble moving the mouth and tongue to speak clearly
Not be able to fully close the eyes
Have trouble holding up the head due to weak neck muscles
Have trouble breathing
Some people with ALS have mood changes. They also might laugh, cry, or yawn at times when it doesn't make sense to do those things. In some people, ALS affects the mind and causes problems with thinking and language. (For example, a person might have trouble finding the right words for things).
Are there tests for ALS? — Yes. Your doctor might be able to tell if you have it by learning about your symptoms and doing an exam. But your doctor will probably do tests, such as electromyography (also called "EMG"), to check how well your nerves and muscles are working. You might also need other tests to check that a different problem isn't causing your symptoms. These might include:
MRI – This is an imaging test that takes pictures of your brain and spinal cord.
Blood and urine tests
How is ALS treated? — Treatments for ALS include a medicine called riluzole (brand name: Rilutek). This medicine works by slowing down the progress of the disease a little bit. It can help people live a few months longer. Another medicine, edaravone (brand name: Radicava), might also help slow the progress of ALS in some people.
Other treatments help people cope with the symptoms of ALS. They include:
Breathing support – For this treatment, you wear a tight-fitting mask on your face or nose. Air and oxygen flow through the mask to help you breathe.
Feeding tube – This is a small, flexible tube that goes through the skin over your belly into your stomach. You can then get special liquid food and fluids through the tube directly into your stomach.
Devices to help with walking and talking, such as:
•A cane, crutches, or motorized wheelchair.
•A special computer that "talks" for you. You can control the computer with hand or eye movements.
Medicines to treat muscle spasms and weakness, drooling, sleep problems, pain, and depression.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 86016 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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