Amyotrophic Lateral Sclerosis (ALS)

Characteristics

Amyotrophic Lateral Sclerosis (ALS) is a severe disorder affecting the nervous system that controls voluntary muscles—those we move consciously, such as the muscles of the limbs and face. In ALS, nerve cells lose their ability to transmit signals to muscle cells, resulting in muscle weakness, wasting, and eventual loss of function. Common symptoms include:

• Muscle weakness and atrophy
• Spasticity
• Muscle twitching (fasciculations)
• Muscle cramps

Prevalence and Disease Course

ALS most commonly affects people in middle age but can occur in children, young adults, or the elderly. Men are slightly more frequently affected than women.

There are two forms of ALS:

1. Sporadic ALS:
   • Accounts for 90–95% of cases.
   • Does not run in families.
   • Likely caused by a combination of genetic and environmental factors.
2. Familial ALS:
   • Occurs in 5–10% of cases.
   • Caused by an inherited genetic mutation.

ALS progresses rapidly, with an average survival time of 3–5 years after diagnosis. Most patients succumb to respiratory failure as the disease progresses.

Cause and Treatment

The exact cause of ALS remains unknown. The sporadic form is believed to be multifactorial, involving both genetic and environmental contributions.

There is currently no cure for ALS. However, the medication riluzole can modestly slow disease progression. Treatment focuses primarily on symptom management, including:

• Physical therapy to maintain mobility and prevent contractures.
• Respiratory support for weakened breathing muscles.
• Nutritional support for swallowing difficulties.
• Medications to reduce spasticity, cramps, and other discomforts.

A multidisciplinary care team, including neurologists, physiotherapists, occupational therapists, and speech therapists, is essential to provide comprehensive support to patients and their families.

Key Considerations

• Timely Diagnosis: Early detection and intervention can improve symptom management and quality of life.
• Supportive Care: Multidisciplinary care is critical for addressing the complex needs of ALS patients.
• Research Advances: Ongoing research aims to better understand the causes of ALS and develop more effective treatments.