Amyotrophic lateral sclerosis (ALS) is a progressive nervous system disorder. It gradually destroys the nerves responsible for muscle movement. Over time, ALS leads to almost total paralysis of muscle movement, including breathing. Eventually, the disorder leads to respiratory failure.
The Nervous System
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Factors that may increase your risk of getting ALS include:
Symptoms of ALS include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. There are no tests that can diagnose ALS. Tests may be used to rule out other medical conditions.
Images may be taken of your bodily structures. This can be done with:
Your bodily fluids and tissues may be tested. This can be done with:
Your muscles and nerves may be evaluated. This can be done with electromyogram (EMG)/nerve conduction velocities (NCV).
Your cognitive skills may be assessed. This can be done with neuropsychological testing.
There is currently no cure for ALS.
Treatment may help to reduce or manage symptoms for a time. A combination of treatments may work best. This may include:
Treatment options include:
The drug riluzole has been approved for ALS. The drug may slightly improve functioning, but it does not stop the disease from progressing.
Your doctor may prescribe these medicines for symptoms:
Supportive care may be needed as ALS progresses, including:
RESOURCES:
ALS Association
http://www.alsa.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov
CANADIAN RESOURCES:
ALS Society of British Columbia
http://www.alsbc.ca
ALS Society of Canada
http://www.als.ca
References:
Aggarwal, SP, Zinman L, Simpson E, et al. Clinical trial testing lithium in ALS terminates early for futility. Lancet Neurol. 2010; 9(5): 481-488.
Amyotrophic lateral sclerosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 8, 2013. Accessed May 21, 2013.
Amyotrophic lateral sclerosis fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm. Updated May 15, 2013. Accessed May 21, 2013.
Sathasivam S. Managing patients with amyotrophic lateral sclerosis. Eur J Intern Med. 2009;24:355-358.
Walling AD. Amyotrophic lateral sclerosis: Lou Gehrig's disease. Am Fam Physician. 1999;59:1489-1496.
4/17/2008 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Fornai F, Longone P, Cafaro L, et al. Lithium delays progression of amyotrophic lateral sclerosis. Proc Natl Acad Sci USA. 2008;105:2052-2057.
1/14/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mateen FJ, Carone M, Sorenson EJ. Patients who survive 5 years or more with ALS in Olmsted County, 1925-2004. J Neurol Neurosurg Psychiatry. 2010;81(10):1144-1146.
Last reviewed May 2013 by Rimas Lukas, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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