Amyotrophic Lateral Sclerosis (ALS)

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Condition: Amyotrophic Lateral Sclerosis (ALS) is also known as Lou Gehrig’s disease. 

Background: In ALS, the nerves that control the muscles die, so the muscles get weak. About 1 or 2 out of every 100,000 people have ALS. ALS gets worse over time and there is no cure.

Risk Factors: Most people with ALS are between 65 and 74. About 10% of the time the disease runs in the family, but usually there is no known cause. More men than women have it. Other things that increase the risk of getting ALS are smoking and head injury.

History and Symptoms: Muscle weakness and shrinkage in the arms and legs are usually the first signs of ALS. Over a few years, the disease spreads to other parts of the body, making it hard to move, swallow, speak, and breathe. 

Physical Exam: The doctor will test mobility, muscle strength and if the muscles are limp or stiff. The exam will also check if there are problems with speech, swallowing, or breathing.

Diagnostic Process: A test called electromyography is done to test the health of the muscles and nerves. MRI may be done to rule out other problems. Blood tests may help predict outcome.  

Rehab Management: In the early stages, drugs and exercise can help with pain and muscle stiffness. Later on, other treatments may be needed to help with feeding and breathing problems, fatigue, and sleeplessness. Wheelchairs, lifts, computer-based communication tools, tube feedings and breathing machines may be needed. A physical medicine and rehabilitation (PM&R) physician is the expert during all stages of this disease and can problem solving how to keep people with ALS as active and independent as possible. A PM&R physician uses rehabilitation therapies such as physical/occupational/speech therapy, braces, specialized equipment and medications to support patients with ALS.

Other Resources for Patients and Families: ALS is scary both for patients and families, so education and support are very important. Visiting nurses or companions can help out. A social worker can help families find the help they need, including planning for the loss of function and end of life.


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