Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease is a type of motor neuron disorder where the nerves present in the spine and brain progressively becomes weak and there will be impaired sending of signals.1 Motor neurons are present in the muscles (smooth and skeletal). It is a progressive neurodegenerative disorder which causes the muscles to lose the function.
Is ALS A Movement Disorder?
ALS is a movement disorder wherein individuals will gradually lose their ability to walk or stand. Arms and legs are progressively weakening and muscles start to shrink. They become abnormally hard and stiff. Drooling and yawn is a common site resulting in jaw pain. The muscles of throat and mouth become weaker making it difficult to eat and talk. The advanced stage requires support to perform all the activities including breathing, lack of supportive care results in death. Respiratory collapse is the most common cause of death.
ALS can happen at any age, but is most prevalent in people who are 40 years and older. It affects men more when compared to women. In the United States, ALS is the most common type of motor neuron disorder. All types of muscles get affected, death usually happens due to the collapse of the respiratory system. The muscle weakness decreases the ability to breathe. During the last stage of the disease, people may be on the ventilator to assist them in breathing.
A number of factors such as genetic, viral, and environmental play a major role in causing motor neuron disorder. The onsets of symptoms of the disease are gradual and often go unnoticed until the symptoms become prominent. Once the muscle weakness or atrophy becomes prominent then the doctor may advise for differential diagnosis for ALS. People who are diagnosed with ALS can live for a maximum of 10 years. The symptoms of ALS can be observed in arm, leg, neck or diaphragm in the form of
- Muscle cramps
- Spasticity of muscles
- Muscles twitches
- Excess salivation, difficulty in swallowing
- Slurred speech
The symptoms appear when the individuals will not be in a condition to perform daily activities such as unbuttoning a shirt or writing. All the body parts are not affected at a time. It usually starts with one arm or leg. People will not be able to coordinate to lift a thing or walk maybe improper giving an awkward appearance, people may fall while walking or running. Depending upon the part affected, ALS is called as “limb onset” ALS or “bulbar onset” ALS. In “bulbar onset” ALS, the changes are first noticed in eating and talking, people will find it difficult to swallow and the speech will not be clear. Soon the muscles weakness and atrophy begins to spread to other parts of the body. The disease progression is characterized by impaired swallowing (dysphagia), dysarthria (difficulty in speech), and difficulty in breathing (dyspnea) with a movement disorder.
Each individual is different and hence the rate of progression of the disease. As the disease progresses people will find it difficult to stand or walk and ultimately spend most of the time sitting or lying on the bed. It becomes difficult to use hands. The metabolic system becomes active and hence they tend to lose weight. Eating and swallowing will be painful and there is an increased risk of choking, hence there will be a decrease in the weight of such individuals. They need adequate nutrition to compensate for low food and increased metabolism.
It is a movement disorder which does not affect the mental functioning of the body. The individuals retain their ability to think, remember, understand and solve the problem. Their deteriorating physical abilities will be a matter of concern for them. But there is increasing evidence that people will ALS will develop dementia. Over a period they may become anxious and depressed and need medical help. People may also develop painful neuropathy and are at increased risk of developing pneumonia.