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Amyotrophic Lateral Sclerosis (ALS) - Topic Overview

What are the symptoms? continued...

Over time, ALS also causes:

  • Muscle twitching.
  • Trouble using your hands and fingers to do tasks.
  • Problems with speaking, swallowing, eating, walking, and breathing.
  • Problems with memory, thinking, and changes in personality. But these are not common.

ALS doesn't cause numbness, tingling, or loss of feeling.

Respiratory problems and problems with swallowing and getting enough food are the most common serious complication of ALS. As the muscles in the throat and chest weaken, swallowing, coughing, and breathing problems tend to get worse. Pneumonia, pulmonary embolism, lung failure, and heart failure are the most common causes of death.

How is ALS diagnosed?

It can be hard for your doctor to tell if you have ALS. It may not be clear that you have the disease until symptoms get worse or until your doctor has done more testing. To find out if you have ALS, your doctor will do a physical exam and will ask you about your symptoms and past health. You will also have tests that show how your muscles and nerves are working.

Just because you have muscle weakness, fatigue, stiffness, and twitching doesn't mean that you have ALS. Those symptoms can also be caused by other conditions. So talk to your doctor if you have those symptoms.

Tests to confirm ALS or look for other causes of your symptoms include:

If your doctor thinks that you have ALS, he or she will refer you to a neurologist to make sure.

How is it treated?

There is no cure for ALS, but treatment can help you stay strong and independent for as long as possible. For example:

  • Physical and occupational therapy can help you stay strong and make the most of the abilities you still have.
  • Speech therapy can help you with coughing, swallowing, and talking after weakness in the face, throat, and chest begins.
  • Supportive devices and equipment can help you stay mobile, communicate, and do daily tasks like bathing, eating, and dressing. Some examples are canes, walkers, wheelchairs, ramps, handrails, raised toilet seats, and shower seats. You can also get braces to support your feet, ankles, or neck.
  • Medicines can help relieve your symptoms and keep you comfortable. There are medicines that can help with many of the symptoms you might have, such as muscle problems (stiffness, cramps, twitching), drooling and extra saliva, depression and mood swings, and pain.
  • A feeding tube can help you get enough nutrition to stay strong as long as you can.
  • Breathing devices can help you breathe more easily as your chest muscles weaken.

A medicine called riluzole (Rilutek) may prolong survival by about 2 months.2 But it doesn't improve symptoms or quality of life in ways that people with ALS, their caregivers, or their doctors have been able to notice. Most people tolerate riluzole very well, but it can cause side effects, including nausea, vomiting, weakness, dizziness, and coughing. Treatment with riluzole is also expensive.

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