ALS Symptoms

ALS, also known as amyotrophic lateral sclerosis or “Lou Gehrig’s disease,” is a disease of the motor neurons that results in the degeneration of neurons located in the spinal cord. The disease progresses rapidly and has few treatment options. However, because of the difficulty in diagnosing ALS, a good understanding of the symptomology and diagnostic process of this disease are key to understanding its development across a variety of patients.

Initial Symptoms: Movement

Many of the earliest symptoms of ALS affect a person’s ability to move in a slight way. Early onset ALS symptoms typically include muscle weakness in the hands, arms, legs, or speech muscles, twitching and cramping of muscles in the hands and feet, and impairment of arm and leg use. The most common of these symptoms is muscle weakness, as it affects approximately 60 percent of individuals diagnosed with ALS. This muscle weakness may manifest itself in a variety of forms including muscle cramps, fatigue, tripping, and dropping things. Individuals typically overlook these symptoms in the early stages as they may attribute them to clumsiness or aging.

Initial Symptoms: Other

In addition to the symptoms affecting the muscular system and body movement, ALS symptoms also include “thick speech” (slurring and hard to understand consonants), difficulty projecting the voice, shortness of breath, and difficulty in breathing or swallowing. However, it should be noted that because ALS only affects motor neurons, it should not affect a person’s five senses. If these are being affected, another condition may be at work, and a medical professional should be notified immediately.

Symptom Progression

ALS symptoms progress at different rates for different individual sufferers. While one patient may experience tripping over carpet edges, other patients may more frequently cite trouble lifting items or slurred speech as the earliest onset symptoms of ALS. Over the course of a person’s illness, ALS symptoms will progressively towards increased muscle weakness and paralysis. ALS symptoms typically begin in the hands and feet and progress throughout the body from there. As the weakness spreads, ALS’s affect on speech, breathing, chewing, and swallowing. This affect on the respiratory system may lead to a person’s increased reliance on ventilatory support to live.

ALS Symptom Timing

The amount of time it takes to progress between these symptoms varies from person to person, but the average survival time for individuals with ALS is between three and five years. However, many individuals live for ten years or longer after the initial onset of symptoms

Types of ALS

Physicians typically agree that there are three main times of ALS in the world today. The most common form is Sporadic ALS that accounts for up to 95 percent of ALS cases in the United States. The next most common is Familial ALS that occurs in individuals who have a genetic dominant inheritance family lineage that contributes to their development of ALS. In families with a predisposition for Familial ALS, there is a 50 percent chance that each child will inherit the mutation that predisposes to later development of ALS. This accounts for between 5 to 10 percent of all cases worldwide. The rarest form is Guamanian ALS that was observed to primarily affect those in Guam and the other US Pacific territories in the 1950′s.

Remission

Some individuals with symptoms of ALS may experience periods of remission, but this is relatively uncommon, and there is currently no medical consensus about how or why this occurs. Some research has shown that newly developed protective practices may increase the chances of remission, but this research is still in the early stages.

ALS Diagnosis

ALS can be difficult to diagnose because there is no single test or procedure that can definitively determine if ALS symptoms are being caused by ALS or something else that mimics ALS’s symptomology. Typically, diagnosis is confirmed through a battery of diagnostic tests and clinical examinations that rule out other (usually more treatable conditions) that may mirror typical ALS symptom development. Most diagnostic workups to diagnose for ALS would include :
-Neurological examination
-Blood and urine studies (including high resolution serum protein electrophoresis, thyroid and parathyroid hormone levels, and heavy metal analysis),
-Diagnostic imaging such as MRI and x-rays,
-Myelogram of cervical spine (radiographic study that uses an injected contrast to detect tumors, cysts, or other spinal cord injuries)
-Biopsies of the muscles and nerves, and
-Electrodiagnostic tests (such as electomyography and nerve conduction velocity) tests.

Confirming an ALS Diagnosis

Because many diseases have symptoms similar to those of ALS, the ALS Association recommends that all people diagnosed with ALS seek a second opinion from an ALS expert who diagnoses and treats a variety of ALS patients. The medical professional providing this second opinion may uncover a different cause for the present symptoms and enable a patient to begin a course of treatment to correct the newly diagnosed illness.