Frequently Asked Questions

Amyotrophic Lateral Sclerosis

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What is amyotrophic lateral sclerosis?

Amyotrophic lateral sclerosis (ALS) is also called Lou Gehrig disease. It affects the nervous system. The nervous system includes your brain, spinal cord, and nerves. In ALS, the motor nerves that direct your muscles to move are damaged. These muscles gradually weaken, waste away, and can begin to twitch. Over time, ALS may lead to total paralysis (not able to move your muscles), including the muscles for breathing. It is a progressive disease that usually ends in death.

What causes ALS?

The cause of ALS is unknown, but may include:

  • Autoimmune disease: An autoimmune disease causes your immune system to attack some part of your body. In ALS, the body attacks its own nerves.

  • Chemical imbalance: Glutamate is a chemical in the brain that sends signals from one nerve to another. Too much glutamate may cause the motor neurons to die.

  • Frequent chemical exposure: ALS may be caused by chemical exposure, such as fertilizers and pesticides used in gardening and lawn care.

  • Genetics: Your risk is greater if a family member has thyroid disease or an autoimmune disease.

  • Infection: Infections can damage the motor neurons.

What are the signs and symptoms of ALS?

The main symptom of ALS is muscle weakness or stiffness which is often in the hands, arms, feet, or legs. The weakness or stiffness worsens over time. You may have any of the following:

  • You may have a weak hand grip, drop things often, or have trouble doing tasks such as opening bottles.

  • You may feel more tired than usual or drag one leg or trip when you walk.

  • Your arm or leg may jerk while you are resting.

  • Your muscles may twitch.

  • You may drool or have trouble speaking.

  • You may have trouble breathing, eating, or swallowing, especially in the later stages of the disease.

How is ALS diagnosed?

  • Electromyography: This test is also called an EMG. It measures the electrical activity in the nerves that control your muscles.

  • Nerve conduction velocity: This test measures the nerve impulses that travel between the spinal cord and muscles.

  • Lumbar puncture: Fluid may be taken from your spine to measure glutamate levels.

  • Magnetic resonance imaging: This test is also called an MRI. Radio waves and a computer are used to take pictures of your brain. You will need to lie still during this test. The MRI machine contains a powerful magnet. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your healthcare provider if you have any metal implants in your body.

How is ALS treated?

There is no cure for ALS. Treatment is focused on trying to ease the symptoms and prevent the disease from getting worse.

  • Medicines:

    • Central nervous system medicine: This medicine reduces the damage to the motor neurons by decreasing the release of glutamate.

    • Other medicines: These medicines may help ease muscle cramps, fatigue, and excessive saliva or mucus caused by ALS.

  • Rehabilitation program: This program may include physical, breathing, and speech exercises.

Where can I find more information?

  • National Institute of Neurological Disorders and Stroke
    P.O. Box 5801
    Bethesda , MD 20824
    Phone: 1- 301 - 496-5751
    Phone: 1- 800 - 352-9424
    Web Address:

What are the risks of ALS?

The medicine used to treat you may cause liver problems. ALS may be difficult to treat. The treatments may or may not control your symptoms. If ALS is not treated, you may have more trouble moving, walking, eating, or breathing. Your health, quality of life, and ability to function may decrease.

When should I contact my healthcare provider?

Contact your healthcare provider if:

  • You have a fever.

  • You have chills, cough, or feel weak and achy.

  • You are depressed and feel you cannot cope with your illness.

  • You have questions or concerns about your condition or care.

When should I seek immediate help?

Seek help immediately or call 911 if:

  • You have severe chest pain.

  • You have trouble breathing all of a sudden.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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