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General Practice 2023

Amiotrófica Lateral Sclerosis (ALS): what é, symptoms and treatment

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Amiotrófica Lateral Sclerosis (ALS): what é, symptoms and treatment
Amiotrófica Lateral Sclerosis (ALS): what é, symptoms and treatment

Amyotrophic lateral sclerosis, also known as ALS, is a degenerative disease that causes the destruction of neurons responsible for the movement of voluntary muscles, leading to a progressive paralysis that ends up preventing simple tasks such as walking, chewing, talking or breathing. and, therefore, it is considered a very serious disease.

Over time, the disease causes a decrease in muscle strength, especially in the arms and legs, and in more advanced cases, the affected person becomes paralyzed and their muscles begin to atrophy, becoming smaller and thinner.

Amyotrophic lateral sclerosis still has no cure, but treatment with physical therapy and drugs, such as riluzole, help to delay the progression of the disease and maintain as much independence as possible in daily activities.

Main symptoms

The first symptoms of ALS are difficult to identify and vary from person to person according to the neurons affected. In some cases it is more common for the person to start tripping over rugs, while in others it is difficult to write, lift an object or speak correctly, for example.

However, as the disease progresses, the symptoms become more evident, starting to exist:

  • Decreased strength in throat muscles;
  • Frequent muscle spasms or cramps, especially in the hands and feet;
  • Deep voice and difficulty speaking louder;
  • Difficulty maintaining correct posture;
  • Difficulty speaking, swallowing or breathing.

Amyotrophic lateral sclerosis appears only in motor neurons, and therefore, the person does not feel pain, or feels very little, with only limitation of motor functions.

How to confirm the diagnosis

Diagnosis is not easy and, therefore, the doctor may perform several tests, such as MRI to rule out other diseases, such as myasthenia gravis or multiple sclerosis, which may cause similar symptoms such as lack of strength or changes to walk, for example. See other symptoms that could indicate multiple sclerosis.

In addition, the doctor may recommend performing a muscle biopsy and electromyography to assess the electrical function of the muscles, as well as complementary tests, such as a blood test and lumbar puncture. Learn how lumbar puncture is performed.

After the diagnosis of amyotrophic lateral sclerosis, the life expectancy of each patient varies between 3 and 5 years, but there have also been cases of greater longevity, such as Stephen Hawking who lived with the disease for more than 50 years.

Possible causes

The causes of amyotrophic lateral sclerosis are still not fully understood.Some cases of the disease are caused by an accumulation of toxic proteins in neurons that control muscles, and this is more common in men aged between 40 and 50 years. But, in a few cases, ALS can also be caused by a hereditary genetic defect, passing from parents to children, and smoking can be considered a risk factor in women.

How the treatment is done

The treatment of ALS must be guided by a neurologist and, normally, it starts with the use of the drug Riluzole, which helps to reduce the damage caused to the neurons, delaying the progression of the disease.

In addition, when the disease is diagnosed in its early stages, the doctor may also recommend physical therapy treatment. In more advanced cases, analgesics such as tramadol can be used to reduce the discomfort and pain caused by muscle degeneration.

As the disease progresses, the paralysis spreads to other muscles and eventually affects the breathing muscles, requiring hospitalization in order to breathe with the help of machines.It is also important that the treatment is guided by the nutritionist, so that the diet is adapted according to the evolution of the disease, and by the psychologist to receive emotional support.

How physiotherapy is performed

Physiotherapy for amyotrophic lateral sclerosis consists of performing exercises that improve blood circulation, increase strength and favor muscle movements, delaying the destruction of muscles caused by the disease. The types of physical therapy can be directed to breathing, speech and to promote independence to carry out daily activities.

The physical therapist can also help teach adaptation to different equipment to ensure the person's independence, such as a wheelchair and braces, for example.

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