Amyotrophic lateral sclerosis (ALS) is also known as Lou Gehrig's disease. It is a progressive neurodegenerative disease. In healthy people, cells in the spinal cord and brain called ‘motor neurons’ control voluntary muscles. In ALS, these motor neurons deteriorate and the strength of the nerve signal that reaches the muscles decreases. Electrical signals from the nerves normally maintain muscle mass, and as these signals decrease, affected muscles shrink and weaken.

Symptoms

The initial and primary symptom is sudden and apparent muscle weakness. If weakness occurs first in the arms or legs, it is called ‘limb-onset.’ If the weakness first manifests as difficulty swallowing or speaking, it is called ‘bulbar-onset.’ Gradually, the weakness spreads to other regions of the body and results in paralysis.

Other symptoms include muscle stiffness, twitching, cramps and exaggerated reflexes. Pain is not specifically a symptom of ALS, but can occur as a result of muscle cramps, loss of muscle strength, and loss of mobility. Involuntary movements, such as eye twitches, bladder and bowel control, and sexual function are not usually affected, nor are touch, vision and hearing. ALS does not affect intelligence or reasoning.

ALS is not necessarily a genetic disease, however. Only 5-10% of the ALS population have a relative with ALS. Most people have ‘sporadic ALS,’ meaning that it occurs randomly. Approximately one out of 10,000 Americans has ALS, and ALS is not contagious.

Most treatments are directed towards relieving symptoms such as muscle twitching, cramps and excessive salivation that can occur as a result of ALS. Drugs, physical therapy, occupational therapy, swallowing/speech therapy, massage, and respiratory therapy are all used in the care of ALS. Ventilators and feeding tubes are used to support life in advanced ALS.