Amyotrophic Lateral Sclerosis (ALS) - Symptoms, causes and treatment

Amyotrophic Lateral Sclerosis (ALS) is a neurological disorder that can get worse over time, leading to paralysis. Initially, ALS is characterized by muscle twitching, muscle weakness, and impaired speech.

ALS or amyotrophic lateral sclerosis is a disease that became famous in 2014 through ice bucket challenge, which is a challenge done by pouring a bucket of cold water over the head. This challenge was created to raise funds for research into this disease.

Specifically, ALS attacks the brain and spinal cord that control muscle movement (motor nerves). This disease is also known as motor nerve disease. Over time, the nerves will be more and more damaged. As a result, ALS sufferers lose muscle strength, the ability to talk, eat, and breathe.

Symptom Amyotrophic Lateral Sclerosis

Early symptoms of ALS often start in the legs and then spread to other parts of the body. As the disease progresses, symptoms will worsen, nerve cells will be damaged, and muscles will continue to weaken, affecting the sufferer's ability to speak, chew, swallow, and breathe.

Symptoms of ALS include:

  • Muscle cramps or stiffness and twitching of the arms and tongue.
  • Arms feel weak and often drop things.
  • The limbs are weak, so they often fall or stumble.
  • Difficulty holding head up and maintaining body position.
  • Difficulty walking and performing daily activities.
  • Speech disorders, such as speaking slurred or too slowly.
  • Difficulty swallowing, choking easily, and drooling from the mouth.

Although it interferes with movement, the disease known as Lou Gehrig's disease does not affect sensory function and the ability to control urination or defecation. People with ALS are also able to think well and interact with other people.

When to go to the doctor

Immediately see a doctor if you feel changes in the muscles of the arms and legs, muscle cramps in the legs, and the body feels weak for several days or weeks. It is also necessary to see a doctor if there are changes in the way you talk or walk.

ALS is a disease that will get worse gradually. If you are diagnosed with amyotrophic lateral sclerosis (amyotrophic lateral sclerosis), do regular check-ups with a neurologist, so that the course of the disease can be monitored more closely.

Reason Amyotrophic Lateral Sclerosis

The cause of ALS or Lou Gehrig's disease is uncertain. However, about 5-10% of ALS cases are known to be hereditary.

In addition to heredity, several studies have shown that ALS is thought to be associated with a number of conditions below:

  • Advantages of glutamate

    Glutamate is a chemical that acts as a sender of messages to and from the brain and nerves. However, when it accumulates around nerve cells, glutamate can cause nerve damage.

  • Immune system disorders

    In people with ALS, the immune system mistakenly attacks healthy nerve cells, causing damage to these cells.

  • Mitochondrial disorders

    Mitochondria are the site of energy production in cells. Disturbances in the formation of this energy can damage nerve cells and accelerate the worsening of ALS.

  • Oxidative stress

    Excessive levels of free radicals will cause oxidative stress and cause damage to various body cells.

Risk Factor Amyotrophic Lateral Sclerosis

There are a number of factors that can increase a person's risk of developing ALS, including:

  • Age between 40-70 years.
  • Have parents who have ALS.
  • Long-term exposure to lead chemicals.
  • Have a smoking habit.

Diagnosis Amyotrophic Lateral Sclerosis

There is no test that can confirm ALS. Therefore, to be able to determine ALS, the doctor will ask in detail about the symptoms experienced by the patient, as well as perform a physical examination.

To rule out the possibility of symptoms being caused by other diseases, the doctor will perform the following tests:

  • Electromyography (EMG), to check the electrical activity of muscles.
  • An MRI scan, to look at the nervous system that is problematic.
  • Test blood and urine samples, to determine the general health condition of the patient, the presence of genetic disorders, or the presence of other causal factors.
  • Examination of nerve conduction velocity, to assess the function of the motor nerves of the body.
  • Sampling (biopsy) of muscle tissue, to see abnormalities in the muscles.
  • Lumbar puncture examination, to examine a sample of cerebrospinal fluid taken through the spine.

TreatmentAmyotrophic Lateral Sclerosis

ALS treatment aims to slow the progression of the disease and prevent complications. Treatment methods that can be given include:

Drugs

To treat ALS, doctors may prescribe the following medications:

  • Baclofen and diazepam, to relieve symptoms of muscle stiffness that interfere with daily activities.
  • Trihexyphenidyl or amitriptyline, to help patients who have difficulty swallowing.
  • Riluzole, to slow the progression of nerve damage that occurs in ALS.

Therapy

Therapy in ALS is done to help muscle function and breathing. The therapies that can be given are:

  • Respiratory therapy, to help patients who have difficulty breathing due to muscle weakness
  • Physical therapy (physiotherapy), to help patients move and maintain physical fitness, heart health, and patient muscle strength.
  • Speech therapy, to help patients communicate well.
  • Occupational therapy, to help patients perform daily activities independently.
  • Regulation of nutritional intake, by providing food that is easy to swallow, but still sufficient for the patient's nutritional needs.

ALS cannot be completely treated. However, the various treatments above can relieve symptoms and help patients carry out their daily activities.

ComplicationsAmyotrophic Lateral Sclerosis

As ALS progresses, sufferers can experience the following complications:

  • Difficulty speaking. The words spoken by ALS sufferers become unclear and difficult to understand.
  • Difficulty breathing. This condition can lead to respiratory failure, which is the leading cause of death in ALS sufferers.
  • Difficulty eating, which can cause the sufferer to lack nutrition and fluids.
  • Dementia, which is a decrease in memory and the ability to make decisions.

Amyotrophic lateral sclerosis is a disease that is difficult to prevent because the cause is unknown. Get regular checkups, especially if you have a family member with ALS, or you have mobility problems.