Imagine that simple tasks you do every day, such as picking up a cup, combing your hair, or climbing stairs, are becoming increasingly difficult. Do you feel like your limbs are going numb, your muscles are shaking, or your words are slurred when you speak? These are the early signs of a serious disease that many people ignore, but they can be. Today we are going to talk about one such disease, namely ALS, or Amyotrophic Lateral Sclerosis.
Simply put, what is ALS?
ALS is a disease that affects our nervous system. To be precise, it is a disease that damages the nerve cells, or neurons, in our brain and spinal cord. We call these neurons motor neurons. Their main function is to take messages from our brain and send them to our muscles. All movements such as "raise your hand", "put your leg forward", "open your mouth" are controlled by these messages.
Think of it like a telephone line from your brain to your muscles. When ALS develops, these telephone lines gradually break down. Then the messages sent from the brain don't reach the muscles properly. The messages get interrupted. Eventually, the connection is lost completely. As a result, the muscles don't get the command to work, so they gradually shrink and atrophy. In medicine, we call this atrophy .
This disease was once known as Lou Gehrig's disease. That's because a famous baseball player in the 1920s and 30s suffered from this disease. There is still no cure for this disease. But don't worry, treatments have been developed to help control the disease, reduce symptoms, and live a comfortable life.
There are two main types of ALS disease.
This disease can be divided into two main types depending on how it occurs.
| ALS type | Simple explanation |
|---|---|
| Sporadic ALS | This is the most common type. About 90% of ALS patients have this type. It occurs randomly, without any known cause. That means it is not passed down from family members. |
| Familial ALS | This is very rare. Only about 10% of patients belong to this type. This is hereditary. This means that the disease can be inherited from parents to children through genes. |
What are the symptoms to look out for?
The symptoms of ALS can vary from person to person and the disease can start in different parts of the body. However, there are some common symptoms.
| Symptom | What happens with this? |
|---|---|
| Muscle weakness | You feel a sense of numbness in your arms, legs, and neck. It becomes difficult to lift weights or walk. |
| Muscle twitching and trembling | It feels like the muscles in your arms, legs, shoulders, and tongue are twitching involuntarily. |
| Muscle stiffness (Spasticity) | The muscles become so stiff and stiff that the limbs cannot be bent or extended. |
| Difficulty speaking | Words become slurred, it becomes difficult to speak clearly, and the voice changes. |
| Difficulty swallowing (Dysphagia) | Food and drink may choke when swallowing. Saliva may also escape from the mouth. |
| Uncontrolled expression of emotions | Suddenly crying or laughing for no reason. |
| Fatigue | I feel very tired even after doing a small task. |
These symptoms may first start in one arm or leg and then spread to other parts of the body over time. The rate of progression of the disease is not the same for everyone.
Very important: As the disease progresses, breathing difficulties may occur. If you feel that you are having difficulty breathing, it is an emergency. You should go to a hospital's Emergency Department (ETU) immediately.
Why does ALS develop? What are the risk factors?
In fact, researchers have not yet found a definitive cause for ALS, but there are several factors that are thought to contribute to it.
- Genetics: The familial form of ALS we discussed earlier is caused by genetic mutations. It has also been found that a small percentage of sporadic ALS patients may have a genetic influence.
- Environmental factors: Exposure to toxic chemicals such as lead and mercury, certain viruses, or severe physical injuries are also thought to contribute to this.
Factors that increase the risk of developing this disease:
- Age: People between the ages of 55 and 75 are at higher risk.
- Gender: Among people under the age of 55, men are slightly more likely to develop the disease than women.
- Military service: Some research has shown that those who have served in the military (especially overseas) have an increased risk of developing ALS. This may be due to exposure to toxic chemicals or intense physical exertion.
How does a doctor diagnose this disease?
ALS is not a disease that can be diagnosed with a single test. There are many other diseases that have similar symptoms. Therefore, your doctor may run a series of tests to rule out other diseases.
These are the tests that are usually done:
- Blood and urine tests: Check for other medical conditions in the body.
- Electromyogram (EMG): This tests the electrical activity of muscles.
- Nerve Conduction Study: Measures the speed at which messages travel through nerves.
- Magnetic Resonance Imaging (MRI): An MRI scan is done to check for any damage or tumors in the brain and spinal cord.
What are the treatments for ALS?
As we mentioned earlier, there is no cure for ALS or a cure for the disease. However, there are several treatments that can slow the progression of symptoms and help patients live more comfortably and independently.
Your doctor and your medical team may recommend treatments such as:
Medications
There are several medications that can help slow the progression of the disease and control some of the symptoms. `Riluzole` and `Edaravone` are two of the main ones. In addition, separate medications are given for things like muscle stiffness, drooling, pain, and depression.
Therapies and Rehabilitation
- Physical Therapy: Provides exercises and advice to help keep muscles strong, prevent joint stiffness, and help you function independently for as long as possible.
- Occupational Therapy: Teaches how to use devices such as wheelchairs and walking aids and how to perform daily tasks more easily.
- Speech Therapy: Training to maintain the ability to speak for as long as possible, to swallow food safely, and to use other methods of communication if necessary.
Nutritional Support
Swallowing difficulties can lead to weight loss. Therefore, it is important to follow the advice of a nutritionist and eat a diet that is easy to swallow and provides the necessary nutrition. In some cases, a feeding tube may be used to deliver food directly to the stomach through the nose or stomach.
Breathing Support
As the disease progresses, the breathing muscles become weak. At that point, equipment such as `Noninvasive Ventilation (NIV),` which delivers air through a mask worn over the nose and mouth, may be needed. In the final stages, the help of a machine that pumps air into the lungs (mechanical ventilation) may be required.
Your mental health is also very important.
Learning that you have a disease like ALS and living with it can be very stressful. Feelings like frustration, hopelessness, anger, depression, and anxiety can occur.
It's normal to feel these kinds of feelings. So, just as you care about your physical health, you should also care about your mental health. Talk to your doctor, family, or a trusted friend about how you're feeling. Seek help from a mental health counselor if necessary.
Take-Home Message
- ALS is a disease that damages nerve cells in the brain and spinal cord, weakening muscle control.
- Symptoms may start small (such as numbness in a hand) and spread to the entire body over time.
- Although there is no complete cure for this, there are many treatments that can slow the progression of the disease and make life more comfortable.
- Difficulty breathing is an emergency . If this happens, go to the hospital immediately.
- Your mental health is just as important as your physical health. Talk to your doctor and loved ones about how you're feeling.
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