HEALTH GUIDE INDEX / A / AMYOTROPHIC LATERAL SCLEROSIS

BASIC INFORMATION

DESCRIPTION

A progressive breakdown of the cells of the spinal cord, resulting in gradual loss of muscle function. This is not contagious or cancerous. Symptoms may be confused with neurologic complications of Lyme disease. It involves the central nervous system and the muscle system, especially in the hands, forearms, legs, head and neck.

FREQUENT SIGNS AND SYMPTOMS

  • Muscle twitching and weakness, beginning in the hands and spreading to the arms and legs. Weakness eventually affects muscles that control breathing and swallowing.
  • Muscle cramps.
  • Stiffening and spasticity of muscle groups.
  • Unexplained weight loss.
  • Slurring of speech.
  • Mental deterioration usually does not occur.
  • Sudden involuntary bursts of laughter or crying.

    • CAUSES

    Unknown.

    RISK INCREASES WITH

  • Age over 40.
  • Family history of ALS.
  • Incidence is highest among those whose occupation demands strenuous physical labor.

    • PREVENTIVE MEASURES

    Cannot be prevented at present.

    EXPECTED OUTCOMES

  • This condition is currently considered incurable. It is usually fatal in 2 to 5 years, but 20% of patients survive 5 years and 10% survive 10 years.
  • Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

    • POSSIBLE COMPLICATIONS

  • Pressure sores caused by immobility.
  • Pneumonia caused by swallowing difficulty and choking.
  • The progressive physical degeneration affects the patient's relationships, career, income, muscle coordination, sexuality and energy.

    • TREATMENT

    GENERAL MEASURES

  • Diagnostic testing will include a electromyography to measure nerve conduction.
  • There is no specific treatment. Supportive care is provided to control symptoms and for complicating emergencies.
  • Obtain good nursing care to prevent pressure sores.
  • Learn to do self-suction in order to handle increased accumulation of secretions in the lungs.
  • Psychotherapy or counseling to learn to cope with disability.
  • Eventual hospitalization or nursing-home care.
  • Patients may benefit from a hospice program or local chapter of the ALS support group. Information available from ALS Association, 21021 Ventura Blvd., Woodland Hills, CA 91364, (800) 782-4747.

    • MEDICATIONS

  • There are no medications to treat ALS.
  • Antibiotics to fight infection if pneumonia develops.
  • Baclofen may help reduce spasticity.
  • Antidepressant may help to decrease saliva production.

    • ACTIVITY

  • Stay as active as possible. Weakness will gradually limit capability. A rehabilitation program can help in maintaining independence as long as possible.
  • Obtain equipment that will aid in mobility, such as walker or wheelchair.

    • DIET

  • If swallowing is difficult, soft, easy-to-swallow foods.
  • May require tube feedings eventually.

    • NOTIFY YOUR PHYSICIAN IF

  • You or a family member has symptoms of amyotrophic lateral sclerosis.
  • Coughing, choking or fever occurs after diagnosis.
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