Amyotrophic lateral sclerosis, or ALS, is a rare group of neurological diseases caused primarily by damage to nerve cells responsible for controlling voluntary muscle movement. Voluntary muscles are responsible for performing movements such as chewing, walking and speaking. ALS disease is progressive and symptoms tend to worsen over time. Currently, there is no treatment option to stop the progression of ALS or provide a complete cure, but research on this subject continues.
What are the symptoms of ALS?
The initial symptoms of ALS manifest differently in different patients. Someone may have trouble holding a pen or coffee cup, while another may have problems with speaking. ALS is typically a progressive disease.
The rate of progression of the disease varies considerably from patient to patient. Although the average survival time for ALS patients is 3 to 5 years, many patients live 10 or more years.
The most common early symptoms of ALS are:
- stumbling while walking,
- Difficulty moving things
- speech impairment,
- swallowing problems,
- Muscle cramps and stiffness
- It can be listed as having difficulty in keeping the head upright.
ALS can affect only one hand at first. Or you may have trouble with just one leg, making it difficult to walk in a straight line. Over time, almost all of the muscles you control become affected by the disease. Some organs, such as the heart and bladder muscles, remain completely healthy.
As ALS worsens, more muscles begin to show signs of the disease. Among the more advanced symptoms of the disease are:
- severe weakness in the muscles,
- decrease in muscle mass,
- There are symptoms such as an increase in chewing and swallowing problems.
What are the causes of ALS?
The disease is inherited from parents in 5 to 10% of cases, while the others have no known cause. Possible causes in this group of patients;
gene mutation. Various genetic mutations can lead to hereditary ALS, causing almost the same symptoms as the non-hereditary form.
chemical imbalance. High levels of glutamate, which is found in the brain and functions to carry chemical messages, have been found in people with ALS. It has been determined as a result of research that excess glutamate causes damage to nerve cells.
dysregulated immune response. Sometimes a person's immune system can attack their body's own normal cells, leading to the death of nerve cells.
Abnormal accumulation of proteins. Abnormal forms of some proteins in nerve cells accumulate in the cell gradually and damage the cells.
How is ALS diagnosed?
The disease is difficult to diagnose at an early stage; because the symptoms can mimic some other neurological diseases. Here are some tests used to rule out other conditions:
- Electromyogram (EMG)
- Nerve conduction study
- Magnetic resonance imaging (MRI)
- blood and urine tests
- Lumbar puncture (The process of taking fluid from the spinal cord by entering the waist with a needle)
- Muscle biopsy
What are ALS treatment methods?
Treatments cannot fix the damage done by the disease; however, it can slow the progression of symptoms, prevent complications, and make the patient more comfortable and independent. An integrated team of doctors and healthcare professionals trained in many fields is needed for treatment. This can prolong your survival and improve your quality of life. Various drugs, physical therapy and rehabilitation, speech therapy, nutritional supplements, psychological and social support treatments are used in the treatment.
There are two different drugs, Riluzole and Edaravone, approved by the FDA for the treatment of ALS. Riluzole slows the progression of the disease in some people. It does this by reducing the levels of a chemical messenger called glutamate, which is often found at high levels in the brains of people with ALS. Riluzole is a medicine taken orally in pill form. Edaravone, on the other hand, is given to the patient through a vein and can cause serious side effects. In addition to these two drugs, your doctor may recommend different drugs to relieve symptoms such as muscle cramps, constipation, fatigue, excessive salivation, sleep problems, depression.