ALS comes in a variety of forms. Each has its own set of symptoms and outcomes.
Impaired speech or swallowing, as well as tongue wasting, is the first or most prominent sign of primary bulbar palsy. Because swallowing and breathing are impaired early in the course of the disease, the result is usually worse.
Muscular weakening and wasting is the main symptoms of progressive muscle atrophy. There is no spasticity and speech and swallowing remain unaffected. These people have a tendency to move at a slower pace.
Spasticity is the major symptom of primary lateral sclerosis, and there is no muscular atrophy. In most cases, the outcome is slightly better.
Making a Probable Diagnosis
Doctors will suspect ALS when muscles become weaker over time, especially if a person's senses are unaffected. The following are the usual criteria for diagnosing ALS:
- lower and higher motor neuron degeneration with confirmed disease progression, either within the same body location or to different body parts
- the absence of Electrodiagnostic (EMG) or pathology (biopsy) evidence of another disease process capable of causing lower and/or higher motor neuron degeneration
- the lack of evidence of other disease processes on neuroimaging (MRI) that may explain the symptoms
To rule out other possible causes of symptoms, a number of tests may be required. Electromyography (EMG) is performed to see if the issue is in the muscle or nerve cells. The electrical activity of the muscle is measured in this test.
Other diseases that might harm or compress nerve cells such as cervical spondylosis, multiple sclerosis, and thyroid problems can be ruled out by a magnetic resonance imaging (MRI) scan of the head or spine.
Your doctor can determine the difference between ALS and other illnesses based on where symptom initially emerged and how they progressed over time.
Prevention and Treatment
ALS cannot be avoided or treated since the specific origins of the illness are unknown. The therapy focuses on symptom management and ensuring that the patient has a decent quality of life. A family doctor, home nurses, a neurologist, respiratory therapists, physical therapists, occupational therapists, dietitians, and social workers will be among the health care professionals engaged.
However, there are medications that can help delay the progression of the disease and alleviate some of the symptoms.
Riluzole* is a drug that appears to extend the lives of some patients with ALS by several months. Riluzole appears to inhibit sodium and calcium channels while also increasing glutamate clearance.
The medicines baclofen and diazepam can be used to treat muscle spasms and cramps. Medications can also be used to reduce the quantity of saliva produced, which can aid those who have lost the capacity to swallow it.
A feeding tube may be inserted into the stomach to prevent choking or breathing food and saliva into the lungs. People who have trouble breathing will ultimately need a respirator. Physical therapy can assist patients in maintaining muscular strength and controlling muscle contractions. Speech therapy can help those who are having trouble speaking or swallowing. Many people will benefit from a motorized wheelchair and communication gadgets that use eye motions.
Although a person's physical condition deteriorates, their mental capacity remains same. It is critical to have adequate emotional support from family and friends in order to cope with the disease's development. End-of-life care is an important part of an ALS treatment. In the late stages of the condition, the patient should have a say in how they are treated. This is generally accomplished through the use of advance directives.
