Amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease, is a progressive neurological disease, causing paralysis and muscle weakness. It is eventually fatal. The disease affects nerve cells in the brain and spinal cord, and the brain loses its ability to control muscle movement. Though there is no cure, ALS can be treated.
Significance
The ALS Association estimates that in the United States, approximately 5,600 people are diagnosed with ALS each year. It's typically diagnosed between ages 40 and 70, although it can be diagnosed in younger people. It's 20 percent more common in men than women, but as people get older, the incidence between men and women becomes more similar.
Types
The ALS Association lists three different types of ALS: sporadic, familial and Guamanian. Sporadic ALS is the most common form of the disease, making up 90 percent to 95 percent of all cases. This type of ALS can strike anyone, regardless of whether the person has a family history of the disease. Familial ALS, also known as FALS, accounts for about 5 percent to 10 percent of ALS diagnoses. FALS is diagnosed when one or more cases of ALS are diagnosed in family lineage. In families with FALS, offspring have a 50 percent chance of inheriting the gene with the ALS-causing mutation, and may also develop the disease. Guamanian ALS was seen in the 1950s, when ALS was seen in high numbers in Guam and the Trust Territories of the Pacific, according to the ALS Association.
Features
Symptoms of ALS typically start off mild. They might not even be noticeable at first. Over time, they become more severe and pronounced. The ALS Association lists symptoms as including weakness in the muscles of speech, hands, arms and/or legs; muscle cramping and twitching, especially in the hands and feet; and speech problems. Not everyone has the same symptoms, but nearly all people with ALS have progressive muscle weakness and eventual paralysis. As the disease progresses, other symptoms may appear, such as trouble breathing and swallowing and shortness of breath.
Identification
Diagnosing ALS is not easy, and there is no single test to diagnose the condition. Many tests are used, and it's by ruling out other diseases and conditions that the ALS diagnosis is confirmed. The Mayo Clinic lists tests that are used, including blood and urine tests, featuring a 24 hour urine collection, to check hormone levels; X-rays and MRIs; muscle and/or nerve biopsies, as well as a spinal tap; a neurological exam; and electrodiagnostic tests.
Treatment
There is no cure for ALS, but treatments can be effective in slowing disease progression and improve quality of life. The Food and Drug Administration (FDA) has approved one drug to treat ALS, called riluzole. The brand name is Rilutek, according to the Mayo Clinic. It's thought that this drug reduces the amount of glutamate in the brain. Other drugs may also be prescribed to help with constipation, pain, fatigue and depression. Other therapies such as physical, occupational and speech therapy may also be used to help treat ALS.
