Amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, is a motor neuron disease. Motor neuron diseases affect the nerve cells that control voluntary muscles and their movement. ALS causes the motor neurons to gradually deteriorate and ultimately die. Initially, patients begin to lose strength in their arms, legs and body. As the disease progresses, muscles that control the diaphragm and chest wall are affected and the patients must breathe with a ventilators. The National Institute of Neurological Disorders and Stroke, most ALS patients die within 5 years of the appearance of the first symptoms.
Riluzole
Riluzole (Rilutek) has been approved by the Food and Drug Administration (FDA) to treat amyotrophic lateral sclerosis. According to the National Institute of Neurological Disorders and Stroke, riluzole is believed to be the first drug to prolong survival in the treatment of ALS. Riluzole reduces the amount of glutamate released in the body. It is believed that this may decrease damage to the motor neurons that affect the voluntary muscles. It is also believed that it may postpone the need for a ventilator.
Medications to Relieve Symptoms
Medications may be prescribed to alleviate symptoms that accompany ALS. Pain relievers, antidepressants and sleep aids can help the patient live a comfortable life for as long as the muscle deterioration allows. Fatigue and muscle cramps may also be treated with medications. Doctors and pharmacists should monitor the patient's medications to avoid drug interactions, and keep dosages at appropriate levels.
Physical Therapy
Physical therapy, speech therapy and the use of special devices can prolong a patient's independence throughout the progression of amyotrophic lateral sclerosis.
Low impact exercises like walking and swimming improve cardiac health and keep muscles strong. Stretching and range of motion exercises are also used to keep muscles pliable and reduce the shortening of muscles as the disease progresses. Braces, walkers, ramps and wheelchairs are used by occupational therapists to keep the patients mobile for as long as possible. Speech therapists are also used to teach patients how to communicate with their eyes or other devices when they can longer communicate with speech.
Nutritional Support
Amyotrophic lateral sclerosis patients are taught how to plan small meals to be eaten throughout the day. This ensures that they get adequate fiber, calories and nutrients. They are also taught which foods are easy to swallow and ones that may cause difficulty. Some patients may have to utilize suction devices to reduce the amount of saliva and phlegm, and prevent choking. When the risk of choking becomes too great, a feeding tube may have to be used to ensure the patient is receiving the proper nutrients.
Respirators to Assist Breathing
As ALS progresses it affects the muscles that control the diaphragm and chest wall. An IPPV, or intermittent positive pressure ventilation, device may be needed when the patient sleeps, to aid in breathing. According to the National Institute of Neurological Disorders and Stroke, these devices artificially inflate the lungs using various external sources. When ALS patients reach the point that the lungs can no longer function on their own, respirators may need to be used full time.
