Amyotrophic lateral sclerosis or ALS is a progressive neurological disorder that is incurable and degenerative. ALS causes nerve cells from the brain and spinal cord that control the movement of smooth muscles (voluntary muscles) gradually become damaged. As a result, this can cause paralysis to death.
Causes of ALS
Although the cause of ALS is not known with certainty, heredity turns out to have a role of around 5-10%. For cases of familial ALS (which is inherited from parents genetically) it is believed to be caused by a defective gene that prevents the body from producing a normal amount of an enzyme called superoxide dismutase.
This enzyme helps neutralize free radicals and highly reactive oxygen molecules, which are produced during metabolism. The adverse effects of this can damage body tissue. Some researchers speculate that defects in this enzyme can also be caused by toxins from the environment.
In addition, viral infections and severe physical trauma may be a contributing factor to ALS. Another theory states that ALS occurs because the nerve cells that control movement get excessive stimulation by a neurotransmitter called glutamate.
Signs and Symptoms of ALS
The following are ALS symptoms that you should recognize:
- Difficulty walking, frequent stumbling or difficulty doing normal daily activities
- Weakness in all parts of the feet or hands
- Speaking raved is not what you think it is
- Difficulty swallowing
- Muscle cramps and twitching in the arms, shoulders and tongue
- Trouble holding the head or maintaining a good body balance
Even so, ALS does not usually affect the intestines or bladder, senses and thinking ability. This allows you to stay active for social interaction.
Early diagnosis of ALS is difficult because this disease looks similar to several other neurological diseases. Some commonly used tests to detect ALS are:
- Electromyogram (EMG). During an EMG, the doctor inserts electrode needles through your skin into various muscles. This test will evaluate the electrical activity of your muscles when the muscles contract and when the muscles are at rest. Abnormalities in muscles can be seen on the electromyogram, which helps the doctor diagnose ALS, or determine whether you have a muscle or nerve condition that can cause symptoms.
- Nerve conduction examination. This examination measures the ability of your nerves to send impulses to muscles in different areas of your body. This test can determine whether you have nerve damage or certain muscle diseases.
- Magnetic resonance imaging (MRI). Using radio waves and strong magnetic fields, MRI can produce detailed images of the brain and spinal cord. MRI can evaluate whether you have a spinal tumor, a hernia in the bone marrow of the neck or other conditions that can cause symptoms.
- Blood tests and urine tests. Analyzing blood and urine samples in the laboratory can help your doctor eliminate other possible causes of signs and symptoms.
- Spinal fluid sampling (lumbar puncture). In this procedure, specialists insert a small needle between two vertebrae in the lower back and take a small amount of cerebrospinal fluid for laboratory testing.
- Muscle biopsy. If your doctor believes you might have a muscle disease other than ALS, you can undergo a muscle biopsy. In this procedure, you will be anesthetized with local anesthesia, then a small portion of your muscle will be removed and sent to a laboratory for analysis.
ALS Treatment and Therapy
The only ALS treatment approved by Food and Drug Administration is a drug riluzole (Rilutek). This drug is believed to slow the progress of ALS in some people because it can reduce glutamate in the brain, a substance that is usually found in the brains of ALS sufferers. To note, riluzole can cause side effects such as dizziness, gastrointestinal disorders and changes in liver function.
Over time, ALS can cause breathing difficulties due to the weakening of some muscles in the body. If this has happened, the doctor will usually provide breathing apparatus.
In some cases, you can choose to breathe through a mechanical ventilator. The doctor will insert a tube in the hole created in front of the neck to be directed to the throat so that the tube is connected to the resprirator.
In addition to the use of drugs and modern medical devices, ALS can also be slowed down by a number of therapies. The following are some commonly used therapies:
- Physical therapy
Physical therapy can overcome the pain to train you to do normal daily activities. Some steps taken are fitness training, heart muscle strength and range of motion. Some movements done through this therapy can help prevent pain and help muscles function properly.
- Occupational therapy
Occupational therapy can help you overcome arm and arm weaknesses to help you move independently for as long as possible. An occupational therapist can also help you understand how to renovate a house to allow safe accessibility to carry out daily activities.
- Speech therapy
Because ALS affects the muscles that you use to talk, this disrupts your communication with others. A speech therapist can teach you adaptive techniques to make your pronunciation clearer and easier to understand.
Until now amyotrophic lateral sclerosis or ALS is a disease that cannot be cured. Therefore the treatment only focuses on slowing down the symptoms and preventing further complications.
As is known, ALS causes quite complex physical, mental and social problems. So you need health professionals to provide optimal care. That way the continuity and quality of life can go well.