A disease that affects one in 100,000 people, amyotrophic lateral sclerosis, or ALS, results from damage to the motor neurons. These neurons send information from the brain to the muscles, resulting in voluntary movements. The destruction of the motor neurons cause patients to lose their ability to move. While Francesco Fornai et al., authors of the article “Lithium Delays Progression of Amyotrophic Lateral Sclerosis,” note that a daily dose of lithium delays the progression of ALS, patients may opt for other treatment options.
Medications
Patients with ALS have medication options other than lithium. MayoClinic.com points out that patients can take riluzole, which the Food and Drug Administration approved as the first medication specifically for ALS. Riluzole may help with ALS by reducing the level of glutamate, a type of neurotransmitter found in the brain. That mechanism of riluzole helps slow the progression of the disease.
Doctors may prescribe other medications to help with specific problems caused by ALS. For example, MedlinePlus notes that patients can take diazepam, a benzodiazepine, or baclofen, a muscle relaxant, to treat muscle spasms. If patients have problems swallowing, they can take amitriptyline, a tricyclic antidepressant, or trihexyphenidyl, an antiparkinsonian drug.
Physical Therapy
Since ALS patients can have problems moving, they can benefit from physical therapy. MayoClinic.com explains that physical therapy for ALS involves low-impact exercises. The physical therapist guides the patient through the exercises, making sure they do not get injured. These exercises help with muscle strength and also work on patients' range of motion. For example, the physical therapist will help a patient with leg extension, which can help with walking.
Occupational Therapy
Patients with ALS may undergo occupational therapy, which teaches them how to use supportive devices. For example, if an ALS patient can no longer walk, he may use a wheelchair. The occupational therapist would help the patient in the use of his wheelchair, such as moving around the house and reaching items. If a patient needs to use a wheelchair, he will need ramps installed in his house. Some patients may start using a brace or walker to help them move and may also undergo occupational therapy to learn how to use these supportive devices. MedlinePlus notes that some patients may use certain supportive devices, like a ventilator, only at night.
Treatments for Swallowing
Because ALS can affect patients' ability to eat and swallow, doctors may recommend specific treatment. MedlinePlus explains that patients who choke when swallowing may undergo gastrostomy. With this surgery, the doctor places a feeding tube into the patient's stomach so she does not choke when ingesting food. Since some patients may lose a large amount of weight, they may benefit from having a nutritionist, who can develop a diet that provides the needed nutrients and is easy to swallow.
Speech Therapy
The loss of muscle control can also impair patients' speaking. MayoClinic.com points out that ALS patients who have problems speaking clearly may need the help of a speech therapist, who can help patients with focusing on how they pronounce words. If a patient has a hard time with speech, the speech therapist may recommend the use of a computer or speech synthesizer.
References
- MedlinePlus Medical Encyclopedia: Amyotrophic Lateral Sclerosis
- MayoClinic.com: Amyotrophic Lateral Sclerosis (ALS) – Treatments and Drugs
- “Proceedings of the National Academy of Science of the United States of America”; Lithium Delays Progression of Amyotrophic Lateral Sclerosis; Francesco Fornai, Patrizia Longone, Luisa Cafaro, Olga Kastsiuchenka, Michela Ferruci, Maria Laura Manca, Gloria Lazzeri, Alida Spalloni, Natascia Bellio, Paola Lenzi, Nicola Modugno, Gabriele Siciliano, Ciro Isidoro, Luigi Murri, Stefano Ruggieri and Antonio Paparelli; February 2008
