Amyotrophic Lateral Sclerosis (ALS) is a degenerative disorder that affects parts of the human central nervous system that controls the voluntary movement of body muscles. It causes a gradual deterioration and the loss of upper and lower motor neurons resulting in slow paralysis of the muscles they control. Motor neurons are nerve cells that extend from the brain to the spinal cord and to muscles throughout the body. Over a short period of time, these motor neurons eventually die, and eventually the brain loses its capability to control voluntary movements, thus causing a total paralysis of the victim.
Amyotrophic Lateral Sclerosis (ALS) is also known as Lou Gehrig’s disease belongs to a wider group of disorders known as motor neuron diseases, which are caused by the gradual degeneration and death of motor neurons. It is so named after Lou Gehrig, a famous baseball player in the United States who died from the disease in 1941.
Symptoms of Amyotrophic Lateral Sclerosis (ALS)
The symptoms of ALS are varied but different victims exhibit different symptoms. The sequence of emerging symptoms vary from one person to another, as they progress at different rates. At the beginning, these symptoms are so hard to pinpoint, however as they develop over time, they worsen and begin to be obvious. Eventually persons who have ALS are not able to stand properly, get out of bed or even use their hands and legs as they used to.
Some of the other symptoms are muscle twitches and muscle weakness affecting the arms and slurred speech. Victims with advanced symptoms will have a difficulty in chewing and swallowing. Because of this they run a high risk of choking.
Over time, victims lose the ability to breathe on their own as a result of the disease affecting the normal rhythmic pattern of the diaphragm and must depend on a breathing aids. They face an increased risk of developing respiratory diseases like pneumonia during the late stages of the disease. People with ALS retain their ability to reason, understand and remember things. As a result of this they may become anxious and depressed.
Individuals with ALS develop breathing problems as the muscles of the respiratory system weaken as the disease progresses. All victims eventually lose their ability to talk and walk. These symptoms get worse and over time the victims become totally paralyzed. Most victims of ALS are dead within 3-4 years after their first diagnosis.
To date, ALS has no known cure, however, better methods of diagnosing this disease may improve the quality of life of the individuals who suffer from it.
Amyotrophic Lateral Sclerosis (ALS) affects people of all races and ethnic backgrounds and although it is more pronounced in the 55-75 age bracket, it can strike at any age. More men than women are affected by the diseases.
According to the ALS Association, 200,000 people are living with ALS around the world.
Amyotrophic Lateral Sclerosis (ALS) is a neurological disease which impacts motor neurons that are involved in muscle movement throughout the body.
Causes of Amyotrophic Lateral Sclerosis (ALS)
ALS can either be of Sporadic or Familial nature. 90% of the victims of ALS suffer from Sporadic ALS. Sporadic ALS occurs at random, while Familial ALS is inherited from parents. Although family members of people with Sporadic ALS at a bigger risk of the diseases, very few will suffer from the debilitating the disease.
The familial form of ALS usually only requires one parent to carry the gene responsible for the disease. ALS cannot be transmitted from one person to another.
Diagnosing ALS
There is no single foolproof test that can provide a definitive diagnosis of ALS. The basic diagnosis is based on the detailed history as the symptoms as observed by a physician by conducting a physical examination of the victim. This is because there are very many other diseases that have symptoms similar to ALS. Appropriate tests can exclude the possibility of other conditions.
To help in the diagnosis, doctors have to conduct other neurologic tests to assess if other symptoms such as muscle weakness, spasticity and atrophy are getting worse over time.
Physicians will review an individual’s full medical history and conduct a neurologic examination at regular intervals to assess whether symptoms such as muscle weakness, atrophy of muscles, and spasticity are getting progressively worse.
Apart from a physical examination, the patients are also taken through a series of muscle tests using magnetic resonance imaging (MRI) tests to view images of the brain and the spinal cord. Electromyography (EMG) is used to detect the electrical activity of muscles. A test known as Nerve Condition Study (NCS) measures electrical activity in the nerves and muscles by assessing its ability to send signals along the nerve to the muscle.
Any disparities or abnormalities would imply that there is some form of damage in the nerve cells.
Treatment of ALS
No cure has been found for ALS. Medical interventions and recent improvement in technology has improved the quality of life of people with ALS. Technological advancements have assisted patients to breathe much easier, move about and communicate with others. These advancements have helped people like the renowned physicist and Professor Stephen Hawking to live longer than was expected. He was not expected to live past the age of 25. He is an exceptional case as he has survived for over 50 years with the disease. The professor delivers his lectures through a special computer which he controls using a muscle on his cheek. He has been paralysed from a very young age but moves around with the assistance of a specialised wheelchair.
Managing the Symptoms Treatment of ALS
In order to ensure that people living with ALS are well taken care of, a solid and proper management of the symptoms of ALS need to be employed.
Victims of ALS are known to suffer from a wide range of problems and a lot of care and support is required to offer the best possible care to them.
Medical professionals such as physical therapists, occupations therapists, nutritionists, doctors and nurses are required to together design treatment plans for different victims. This requires a multi-disciplinary approach that is aimed provide a comfortable living to them. Some of these treatments include:
Physical Therapy:
By using specially designed equipment can improve muscle movement. Aerobics exercises like swimming and walking can strengthen unaffected muscles. These exercises can also improve in breathing. Muscle spasticity can be reduced by conducting stretch exercises
Speech Therapy:
ALS victims can benefit from working with speech therapists to help them maintain the ability to communicate. Computer aided speech synthesisers can also be used to help victims to communicate. Non-verbal techniques can also be developed to relay information.
Nutritional Therapy:
This is a very integral part of care of people living with ALS as they lose weight and have an extraordinary rate of metabolism. This leads to an abnormal weight loss in ALS victims. Nutritionists can design meal plans that provide proper nutrition.
Medical Support:
The Food and Drug Agency (FDA) has approved and allowed the use of Riluzole, which contains compounds that are believed to reduce damage to motor neurons. Clinical trials have shown that it prolongs the survival of nerve cells.
Other drugs can be prescribed to manage symptoms such as depression and muscle cramps. Doctors can also advise on the best use of medications to avid the risks of contra-indication of the drugs.
Breathing Support:
ALS victims experience breathing problems during physical activity or when lying down, occasioned them the muscles in the diaphragm grow weak. A breathing support is recommended in order to help these individuals as they carry out their daily duties.
ALS Research
One of the many goals in the research on ALS is to understand the cellular mechanisms involved in the development of the disease and investigate the progression of the disease. The other goal would be to probe influence of genetics and other potential risk factors.
Research will also help scientists to identify biomarkers and develop new and more effective treatments.
In the pursuit of new treatments, scientists around the world are exploring new avenues of research. They are presently testing a number of strategies and treatments in order to reduce the effects of ALS and eventually find a cure. A number tests of human clinical nature have been conducted. Laboratory tests have also been used to develop treatment for ALS.
It is important to note that one of the most significant breakthroughs in the last decade has been the discovery of a number of genes that, when flawed, cause ALS. Genes responsible for causing ALS are now known. The discovery of these genes has been a very important development in that allows the research, understand and isolate the causes of ALS with a view to design therapies to target the genes.
Stem cells are in development as cell-transplantation therapies. Theoretically, stem cells could be used to replace ALS-affected motor neurons; replace other types of cells, such as astrocytes; or release supportive proteins to help ailing nerve cells.
Our Stem Cell Therapy involves the transplantation of Mesenchymal Stem Cells into our patients in combination with other therapies.
Mesenchymal Stem Cells are used as they have a unique ability to provide the host tissue with growth factors and to modulate the host immune system.
Mesenchymal Stem Cells (MSCs) are multipotent Stem Cells that are found in bone marrow and are important for making and repairing skeletal tissues, such as cartilage, bone and the fat found in bone marrow. MSC’s should not be mistaken for Hematopoietic Stem Cells that are also found in the bone marrow. They make up a very small fraction of all the cells in our bone marrow.
These cells are multipotent and have the ability to produce more than one type of specialised cell of the body and differentiate into cells of many types, namely Osteocytes (bone cells), Chondrocytes (cartilage cells) and Adipocytes (fat cells).
Mesenchymal Stem Cells also differentiate into neurons, glial cells and astrocytes thus replacing the injured or dead neurons. They release growth factors including brain derived neurotrophic and nerve growth factors. These stimulate resident Neural Stem Cells and promote communication between neurons, which speeds up the recovery process.
We ensure that our patients get a combination of the best remedies and rehabilitative therapies, including physical and occupational therapy. We also make sure that the patients’ well-being is taken care of in a very clean and welcoming environment at our world class facilities based in Bangkok, Thailand.
We have treated patients from as far as Australia and the United States. Our former clients will give testimony that they have noticed an improved quality of life after undergoing treatment and rehabilitation. Some have regained use of their hands and legs after a short period of therapy and are continually improving. There are some who were brought in wheelchairs but are now able to move independently with little or no aid at all.
H/T: National Institute of Neurological Disorders and Stroke
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