Lou Gehrig's disease, also called amyotrophic lateral sclerosis, or ALS, is a disease affecting the motor neurons, or nerve cells responsible for movement. This progressive, degenerative disease causes muscle weakness, paralysis and death. The text, "Medical Surgical Nursing" explains that it may strike at any age, but is more common in the fifth, six or seventh decade of life.
Early Signs and Symptoms
Early signs and symptoms often cause an individual to seek testing for Lou Gehrig's disease. Typically, the sufferer experiences slurred speech, a twitching muscle or weakness in a limb, explains the Mayo Clinic. During initial testing, the physician performs a physical examination and, typically, blood and urine testing, to rule out other conditions. Genetic testing may be performed and the physician may perform in-office tests to determine whether certain muscles are weaker than they should be. The patient may be sent to a neurologist for a neurological examination. At this point, increasingly sophisticated tests may be ordered.
Biopsies
A muscle biopsy may be performed to rule out muscular diseases. During this testing, a small piece of muscle is removed and then examined in the laboratory. Similarly, a nerve biopsy is sometimes ordered, relates the ALS Association.
Other Tests
Several other tests may be ordered to reach a diagnosis of ALS. A nerve conduction study may be done to measure the strength and rapidness of nerve impulses. It is conducted on an area where the patient is experiencing weakness. Electrodes are placed and small, rapid electrical shocks are passed through a nerve in a weak muscle to determine if the weakness is due to a muscular cause or ALS. A lumbar puncture, or spinal tap, may be performed to collect spinal fluid, which is then analyzed in a laboratory.
An electromyogram, which is a test to evaluate the electrical discharges made by muscles during movement, may be performed. This test, which compares electrical impulses at rest versus impulses made during movement, allows the physician to determine if sensory nerves are functioning normally while motor nerves are not--an indication of ALS, explains the Mayo Clinic. Magnetic resonance imaging, or MRI, of the brain and spinal cord may be ordered to rule out other conditions.
Diagnosis
The treating physician, often a neurologist, will make a diagnosis of Lou Gehrig's disease based on one or more test results plus the physical examination. The physician or a nurse may begin to educate the patient and family on what to expect as symptoms progress.
After Diagnosis
Medication may be ordered to treat disease symptoms. Speech therapy, respiratory therapy, occupational therapy and physical therapy may be needed at different points in the disease process. The physician may order additional testing from time to time, to determine impairment of respiratory function, to determine swallowing ability or for other reasons. The patient may eventually require ventilatory assistance to breathe.
References
- "Medical-Surgical Nursing"; Donna Ignatavicius, M.S., R.N. and Linda Workman, Ph.D., R.N.; 2002
- MayoClinic.com: Amytrophic Lateral Sclerosis
- Mayo Clinic: Lou Gehrig's Disease: Diagnosis
- National Institute of Neurological Disorders and Stroke: Amyotrophic Lateral Sclerosis Information Page
- ALS Association: Diagnosing ALS
