Learn About Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)

What is the definition of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in the brain, brain stem and spinal cord that control voluntary muscle movement.

ALS is also known as Lou Gehrig disease.

What are the alternative names for Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Lou Gehrig disease; ALS; Upper and lower motor neuron disease; Motor neuron disease

What are the causes of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

One in 10 cases of ALS is due to a genetic variant. The cause is unknown in most other cases.

In ALS, motor nerve cells (neurons) waste away or die, and can no longer send messages to muscles. This eventually leads to muscle weakening, twitching, and an inability to move the arms, legs, and body. The condition continues to get worse. When the muscles in the chest area stop working, it becomes hard or impossible to breathe.

ALS affects approximately 7 out of every 100,000 people worldwide.

Having a family member who has a hereditary form of the disease is a risk factor for ALS. Other risks include military service. The reasons for this are unclear, but it may have to do with environmental exposure to toxins.

What are the symptoms of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Symptoms usually do not develop until after age 50, but they can start in younger people. People with ALS have a loss of muscle strength and coordination that eventually gets worse and makes it impossible for them to do routine tasks such as going up steps, getting out of a chair, or swallowing.

Weakness can first affect the arms or legs, or the ability to breathe or swallow. As the disease gets worse, more muscle groups develop problems.

ALS does not affect the senses (sight, smell, taste, hearing, touch). Most people are able to think normally, although a small number develop dementia, causing problems with memory.

Muscle weakness starts in one body part, such as the arm or hand, and slowly gets worse until it leads to the following:

  • Difficulty lifting, climbing stairs, and walking
  • Difficulty breathing
  • Difficulty swallowing -- choking easily, drooling, or gagging
  • Head drop due to weakness of the neck muscles
  • Speech problems, such as a slow or abnormal speech pattern (slurring of words)
  • Voice changes, hoarseness

Other findings include:

  • Depression
  • Changing expressions of emotions (emotional lability)
  • Muscle cramps
  • Muscle stiffness, called spasticity
  • Muscle contractions, called fasciculations
  • Weight loss
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What are the current treatments for Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

There is no known cure for ALS. Two medicines are available that help slow the progression of symptoms and may help people live slightly longer:

  • Riluzole (Rilutek)
  • Edaravone (Radicava)

Treatments to control other symptoms include:

  • Baclofen or diazepam for spasticity that interferes with daily activities
  • Trihexyphenidyl or amitriptyline for people with problems swallowing their own saliva

Trials of gene therapy are now underway for some specific hereditary causes.

Physical therapy, rehabilitation, use of braces or a wheelchair, or other measures may be needed to help with muscle function and general health. Ongoing oversight by a physical medicine provider is helpful, given continuously changing symptoms.

People with ALS tend to lose weight. The illness itself increases the need for food and calories. At the same time, problems with choking and swallowing make it hard to eat enough. To help with feeding, a tube may be placed into the stomach. A dietitian who specializes in ALS can give advice on healthy eating.

Breathing devices include machines that are considered non-invasive (such as CPAP or BiPAP). Others require tube in the trachea (invasive ventilation).

Medicine for depression may be needed if a person with ALS is diagnosed with depression. They also should discuss their wishes regarding artificial ventilation with their families and providers.

Who are the top Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease) Local Doctors?

University Of Texas Health Science Center At San Antonio

8300 Floyd Curl Dr, 
San Antonio, TX 
 8.1 mi
Accepting New Patients
Offers Telehealth

Carlayne Jackson is a Neurologist in San Antonio, Texas. Dr. Jackson and is rated as an Elite provider by MediFind in the treatment of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease). Her top areas of expertise are Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease), Primary Lateral Sclerosis, Myasthenia Gravis, Spinal Muscular Atrophy (SMA), and Thymectomy. Dr. Jackson is currently accepting new patients.

University Of Texas Health Science Center At San Antonio

8300 Floyd Curl Dr, 
San Antonio, TX 
 8.1 mi
Accepting New Patients

Matthew Wicklund is a Neurologist in San Antonio, Texas. Dr. Wicklund and is rated as a Distinguished provider by MediFind in the treatment of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease). His top areas of expertise are Limb-Girdle Muscular Dystrophy, Inclusion Body Myositis, Limb-Girdle Muscular Dystrophy Type 2I, and Paramyotonia Congenita. Dr. Wicklund is currently accepting new patients.

 
 
 
 
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University Of Texas Health Science Center At San Antonio

903 W Martin St, 
San Antonio, TX 
 0.6 mi
Accepting New Patients

Yun Shi is a Family Medicine provider in San Antonio, Texas. Dr. Shi and is rated as an Experienced provider by MediFind in the treatment of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease). Her top areas of expertise are Primary Lateral Sclerosis and Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease). Dr. Shi is currently accepting new patients.

What are the support groups for Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Emotional support is vital in coping with the disorder, because mental functioning is not affected. Groups such as the ALS Association may be available to help people who are coping with the disorder.

Support for people who are caring for someone with ALS is also available, and may be very helpful.

What is the outlook (prognosis) for Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Over time, people with ALS lose the ability to function and care for themselves. Death often occurs within 3 to 5 years of diagnosis. About 1 in 4 people survive for more than 5 years after diagnosis. Some people live much longer, but they typically need help breathing from a ventilator or other device.

What are the possible complications of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Complications of ALS include:

  • Breathing in food or fluid (aspiration)
  • Loss of ability to care for self
  • Lung failure
  • Pneumonia
  • Pressure sores
  • Weight loss
When should I contact a medical professional for Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

Contact your provider if:

  • You have symptoms of ALS, particularly if you have a family history of the disorder
  • You or someone else has been diagnosed with ALS and symptoms get worse or new symptoms develop

Increased difficulty swallowing, difficulty breathing, and episodes of apnea are symptoms that require immediate attention.

How do I prevent Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?

You may want to see a genetic counselor if you have a family history of ALS.

What are the latest Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease) Clinical Trials?
A Phase 2a, Double-Blinded, Randomized, Placebo-Controlled, and Active-Treatment Extension Study to Assess the Safety, Tolerability, Efficacy, Pharmacokinetics, and Immunogenicity of ARGX-119 in Participants with Amyotrophic Lateral Sclerosis

Summary: This study aims to evaluate the safety of ARGX-119 in adults with ALS. The study will also assess the impact of ARGX-119 on ALS disease outcomes, including muscle function. The study consists of 2 periods: a treatment period when participants will receive one of three ARGX-119 doses or placebo and an extension period when all participants will receive the same dose of ARGX-119. Participation in th...

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Evaluating Verbal Communication in Structured Interactions: Theoretical and Clinical Implications

Summary: The goal of this clinical trial is to learn about the effect of communicative interaction on verbal communication in people with amyotrophic lateral sclerosis (ALS) and age-matched speakers. The question is, What are the effects of communicative interaction on verbal communication in people with ALS? Participants will read words and sentences while they are in a solo setting and interactive settin...

What are the Latest Advances for Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's Disease)?
Who are the sources who wrote this article ?

Published Date: June 13, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Fearon C, Murray B, Mitsumoto H. Disorders of upper and lower motor neurons. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 97.

Shaw PJ, Cudkowicz ME. Amyotrophic lateral sclerosis and other motor neuron diseases. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 387.