A Closer Look at ALS
Do you know someone who participated in the ALS Ice Bucket Challenge? With countless videos flooding the Internet, chances are the answer is yes. After the challenge has come and gone, will you know more about ALS? If your answer is no, you’re not alone. While the ALS initiative has raised the profile of the disease, real awareness still remains a challenge. John K. Lynch, DO, MPH, an osteopathic neurologist from Bethesda, Maryland, provides key information to help increase your understanding of this life-altering disease.
What is ALS?
According to Dr. Lynch, amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a rapidly progressive and fatal neurological disease that attacks the nerve cells responsible for controlling the voluntary muscles in the arms, legs, and face. “Normally, nerve cells located in the brain, brain stem, and spinal cord serve as controlling units and vital communication links between the nervous system and the voluntary muscles of the body,” explains Dr. Lynch. “For people with ALS, these nerve cells die and stop sending messages to muscles,” he continues. “Unable to function, the muscles gradually weaken and waste away, eventually eliminating the ability of the brain to start and control voluntary muscle movement,” he adds. “With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.”
What are the Signs?
“The onset of ALS may be so subtle that the symptoms are overlooked; however, there is a combination of signs that can help your doctor in their diagnosis,” says Dr. Lynch. These signs include:
“Commonly, individuals first see the effects of the disease in the legs, hand or arm; and simple tasks such as buttoning a shirt, writing, turning a key in a lock, walking or running become difficult,” says Dr. Lynch. “As the disease progresses, problems with moving, swallowing, and forming words develop, along with worsening muscle weakness and breakdown,” he continues. “Although the sequence of emerging symptoms and the rate of disease progression vary from person to person, eventually individuals won’t be able to stand or walk, get in or out of bed on their own, or use their hands and arms,” he explains. “And, unfortunately, in the later stages of the disease, individuals will lose the ability to breathe on their own and depend on ventilator support for survival.”
No single test can provide a definitive diagnosis of ALS. “Typically, a physician will base their diagnosis on an individual’s medical history, observed symptoms, a series of tests to rule out other diseases, and a neurologic examination at regular intervals to assess whether symptoms such as muscle weakness and breakdown are getting progressively worse,” explains Dr. Lynch. Because of the prognosis carried by this diagnosis and the variety of diseases or disorders that can resemble ALS in the early stages, Dr. Lynch recommends patients obtain a second neurological opinion for confirmation of the disease.
Unfortunately, there is no cure for ALS. “However, a physician who specializes in the disease can prescribe a treatment plan, including exercise and prescription drugs to help relieve symptoms and improve quality of life,” says Dr. Lynch. “They may also recommend gentle stretching exercises and low-impact aerobic exercise such as walking, swimming, and stationary bicycling to help strengthen unaffected muscles and improve cardiovascular health. A sleep ventilation device may help sufferers who experience difficulty breathing during sleep,” he adds. Generally, most people with ALS die from respiratory failure, usually within three to five years from the onset of symptoms. “However, there is hope,” says Dr. Lynch. “Approximately 10% of those with ALS survive for 10 or more years.”
Developing an ALS Plan of Action
For people diagnosed with ALS, regularly consulting a physician who specializes in the disease is the best plan of action. “They can explain the course of the disease and available treatment options so that you can make an informed decision,” says Dr. Lynch.