Amyotrophic Lateral Sclerosis

(ALS; Lou Gehrig's Disease; Motor Neuron Disease)

Definition

Amyotrophic lateral sclerosis (ALS) is a progressive nervous system disorder. It gradually destroys the nerves responsible for muscle movement. Over time, ALS leads to almost total paralysis of muscle movement, including breathing. Eventually, the disorder leads to respiratory failure.
The Nervous System
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Causes

The cause of ALS is unknown. Genes may play a role.

Risk Factors

Factors that may increase your chance of ALS include:
  • Having a family member with ALS
  • Being in the military or having other occupations with risk of exposure
  • Having certain genetic mutations

Symptoms

Symptoms of ALS include:
  • Progressive weakness in arms and legs
  • Wrist or foot drop
  • Difficulty holding things
  • Frequent tripping while walking
  • Muscle twitching
  • Unpredictable and changing emotions
  • Slurred speech
  • Hoarseness and coughing
  • Trouble chewing and swallowing, resulting in frequent choking and gagging
  • Weight loss due to trouble eating
  • Trouble breathing
  • Excess salivation, drooling

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. There are no tests that can diagnose ALS. Tests may be used to rule out other medical conditions.Imaging tests may include:Other tests may include:
  • Blood tests
  • Lumbar puncture to evaluate cerebrospinal fluid that surrounds the brain and spinal cord
  • Biopsy to evaluate tissue under a microscope
Your muscles and nerves may be evaluated. This can be done with electromyogram (EMG)/nerve conduction velocities (NCV). Your cognitive skills may be assessed. This can be done with neuropsychological testing.

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