What is amyotrophic lateral sclerosis (als)?

Amyotrophic lateral sclerosis (ALS) is a disease in which certain nerve cells called motor neurons in the brain and spinal cord slowly die. These nerve cells control the muscles that allow you to move parts of your body. Over time, ALS often makes it hard to walk, speak, eat, swallow, and breathe. ALS is also called Lou Gehrig's disease.

ALS is rare. It can occur at any age, but it most often starts in middle-aged and older adults. Men get ALS slightly more often than women do.

It can be very scary to learn that you have ALS. Talking with your doctor, getting counseling, or joining a support group may help you deal with your feelings.

The first sign of ALS is often weakness in one leg, one hand, or the face. Or it can be having a hard time talking or swallowing. The weakness slowly spreads to both arms and both legs. This happens because as the motor neurons slowly die, they stop sending signals to the muscles. So the muscles don't have anything telling them to move. Over time, with no signals from the motor neurons telling the muscles to move, the muscles get weaker and smaller.

Over time, ALS also causes:

• Muscle twitching.
• Trouble using your hands and fingers to do tasks.
• Problems with speaking, swallowing, eating, walking, and breathing.
• Problems with memory and thinking.
• Changes in personality.

ALS doesn't cause numbness or loss of feeling.

Your doctor will do a physical exam and ask about your symptoms and past health. You'll also have tests that show how your muscles and nerves are working.

Having muscle weakness, fatigue, stiffness, and twitching doesn't mean that you have ALS. Those symptoms can also be caused by other conditions.

It can be hard for your doctor to tell if you have ALS. It may not be clear that you have the disease until symptoms get worse or until your doctor has done more testing.

Tests to confirm ALS or look for other causes of your symptoms include:

• Electromyogram (EMG), which helps measure how well nerves and muscles work.
• Magnetic resonance imaging (MRI), which can show problems or injury in the brain.
• Nerve conduction studies to test nerve function.

If your doctor thinks that you have ALS, you'll be referred to a neurologist to make sure.

There is no cure for ALS, but treatment can help you stay strong and independent for as long as possible. Treatment may include:

• Physical and occupational therapy.

  These therapies can help you stay strong and make the most of the abilities you still have.

• Speech therapy.

  This can help you with coughing, swallowing, and talking after weakness in the face, throat, and chest begins.

• Supportive devices and equipment.

  These can help you stay mobile, communicate, and do daily tasks like bathing, eating, and dressing. Examples include a cane, a walker, a wheelchair, ramps, handrails, and foot or ankle braces.

• Medicines.

  These may help slow the progression of ALS, relieve your symptoms, and keep you comfortable.

• A feeding tube.

  This can help you get enough nutrition to stay strong as long as you can.

• Breathing devices.

  They can help you breathe more easily as your chest muscles weaken.

• Exercise and stretch your muscles as long as you can. Talk to a physical therapist about exercises you can do.
• Eat small, frequent meals. Choose soft foods that are easy to swallow. Try to sit up when you eat. Eat slowly.
• Learn about devices that can help you avoid injury and stay independent:
  • A neck (cervical) collar can support your head if the neck muscles get weak.
  • Foot and ankle braces, a cane, a walker, or a wheelchair can help you move around.
  • A ramp over stairs can allow you to get into and out of your house in a wheelchair.
  • Handrails or a shower seat can keep you from falling in the shower. A higher toilet seat can help you go to the bathroom by yourself.
  • If you have trouble talking, a voice amplifier or an erasable writing pad can help you communicate.
• Consider joining a support group. Sharing your experiences with other people who have the same problem may help you learn more and cope better.
• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• If you have not already done so, prepare a list of advance directives. These are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.