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Amyotrophic lateral sclerosis (ALS) is a very serious condition involving damage to the central and / or peripheral nervous system. The main symptoms include limb muscle wasting, muscle fasciculations, and a gradual loss of mobility. Treatment is only aimed at alleviating the symptoms and rehabilitating the patient.
ALS or amyotrophic lateral sclerosis is a problem of the motor neuron and a neurodegenerative disease. It is characterized by the gradual damage to the nerve fibers that are responsible for the work of the muscles and neurons that are found in the brain and help us move.
The first symptoms of amyotrophic lateral sclerosis (ALS) usually appear between the ages of 50 and 70, less often the ailment affects younger people. The disease is slightly more common in men than in women. Its course varies from person to person, and it may lead to paresis of the lower limbs and a slow loss of mobility.
Causes of Amyotrophic Lateral Sclerosis (ALS)
The causes of amyotrophic lateral sclerosis are not entirely clear. It is said that ALS can be caused by various types of immunological diseases, the action of free oxygen radicals, the action of toxins or as a result of viral infections. Some patients are affected genetically, and the following mutations are responsible for the familial form of ALSIN: SOD1, ALSIN, VABP and SETX, as well as gene polymorphisms on chromosome 9 and 19.
Amyotrophic lateral sclerosis (ALS) – symptoms
Damage to peripheral nerve fibers leads to:
- muscle wasting
- muscle weakness,
- the appearance of muscle tremors.
The type and severity of the first symptoms of amyotrophic lateral sclerosis is very individual. There may be, for example, weakening of the hand and shoulder muscles, which at the beginning are limited to only one hand, with time attacking the other limb as well. If your central nervous system is damaged in the early stages of ALS, you may notice an increase in muscle tone (spasticity). Most often, the disease progresses slowly over the years, and its course is mild (the disease attacks the motor nerves, while mental performance remains intact).
Amyotrophic lateral sclerosis causes the patient’s speech to become slurred and slower, and uttering any words is an enormous effort for him. It only takes a few months for speech problems to develop into problems with swallowing. The consequence of this condition are problems with eating, biting or chewing, which usually result in malnutrition of the patient. Some may even develop excessive drooling. In addition, muscle failure in ALS causes secretion in the airways that is difficult to remove. Over time, respiratory failure develops and lungs become infected. In addition to all the symptoms of ALS, it is worth mentioning depression, insomnia and emotional disorders that often accompany the disease.
Patients with this ailment are also doomed to pain that occurs as a result of muscle cramps, spasticity or being in quite uncomfortable positions. Especially stress, a slight change in temperature and depression intensify the pain. It is worth mentioning that people with ALS very often struggle with mood swings, anxiety and insomnia, which may be caused, for example, by hypoxia and progressive respiratory failure.
In this regard, taking CBD can help to relieve stress as well as symptoms of depression.
We divide Amyotrophic Lateral Sclerosis into three types:
- peripheral sclerosis – damage to the peripheral neuron;
- bulbar sclerosis – characterized by problems with swallowing and articulation, atrophy of the tongue muscles and weakness in the limbs;
- pyramid sclerosis – increased muscle tension, tremors and Babinski’s symptom.
If one of our loved ones has developed amyotrophic lateral sclerosis, the likelihood that other family members will get the disease is low. Nevertheless, the genetic background of the ailments has been proven in 5% of disease cases.
Thus, if several members of the same family become ill with ALS, it will be necessary to test for hereditary burden. Currently, there is no method that can diagnose ALS before its first symptoms appear.
Amyotrophic lateral sclerosis – diagnosis
The doctor who diagnoses amyotrophic lateral sclerosis (ALS) is a neurologist, and a visit to this specialist requires a referral from another doctor (e.g. family doctor). The diagnosis of ALS is based on the performance of electrophysiological tests (electromyography, electroneurography) and imaging tests, e.g. central nervous system resonance. The specialist often orders a blood test to analyze GM1 antibodies and the cerebrospinal fluid. The diagnosis of the disease (differential diagnosis) should take into account, inter alia, pseudomembrane syndrome, multiple sclerosis, and myasthenia gravis.
In a situation where there is a suspicion of hereditary disease – genetic tests are performed.
The appearance of clinical symptoms of damage to the peripheral and central motor neurons in the bulb and in two other segments of the spinal cord or trauma in the three spinal segments – indicates disease (according to EL Escorial SLA).
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What is the differential diagnosis (determining the patient’s health status and the causes of the disease)?
Doctors consider the following factors in their differential diagnosis:
- pseudo-bulb syndrome,
- postpolio team (post-paralysis syndrome),
- myasthenia gravis (rapid fatigue and skeletal muscle weakness),
- multiple sclerosis,
- multifocal motor neuropathy with conduction block,
- muscle wasting in one limb (aka Hirayama syndrome),
- Denny-Brown and Foley syndrome.
What factors exclude amyotrophic lateral sclerosis?
- problems with keeping stools or urine,
- trouble with eyesight,
- sensory symptoms
- long duration of the disease,
- autonomous irregularities,
- Alzheimer’s disease,
- symptoms of senile dementia,
- extrapyramidal disorders.
Treatment of amyotrophic lateral sclerosis (ALS)
Due to the lack of a tangible cause for amyotrophic lateral sclerosis (ALS), no effective treatment has yet been developed. Therapy used in ALS patients is aimed at alleviating the symptoms and improving the patient’s quality of life.
The therapy consists of:
- conducting therapeutic gymnastics: thanks to exercise, it is possible to activate the preserved muscle functions and prevent joint stiffness. Swimming and water exercises are also recommended;
- the use of drugs that reduce muscle spasticity;
- special preparation of meals (in the form of mush) – if there are problems with chewing and swallowing;
- performing speech therapy exercises – if there are speech disorders.
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