Amyotrophic Lateral Sclerosis (ALS)
The initial symptoms of ALS may be so subtle that they are overlooked. The course of the disease may include the following:
- twitching (fasciculation) and cramping of muscles, especially those in the hands and feet
- muscle weakness in one or more of the following: hands, arms, legs or the muscles controlling speech, swallowing or breathing
- impairment of the use of the arms and legs
- "thick speech" and difficulty in projecting the voice
- in more advanced stages, shortness of breath, difficulty in breathing and swallowing
The initial symptoms of ALS and the rate of progression can vary significantly from patient to patient. Although the average survival time with ALS is three years from diagnosis, some people live five, 10, or more years. Not all people with ALS experience the same symptoms or the same sequences or pattern of progression. But, progressive muscle weakness and paralysis are universally experienced. As the weakness continues to spread, the disease eventually affects walking, speech, swallowing, and breathing. When the breathing muscles become affected, ultimately, the patient will need permanent respiratory support in order to survive.
Since ALS attacks only motor neurons, the sense of sight, touch, hearing, taste and smell are not affected. For many people, muscles of the eyes and bladder are generally not affected. For the vast majority of people, their mind and thoughts are not impaired and remain sharp despite the progressive degenerating condition of the body.
Diagnosis of ALS
To date, there is no one definitive test or procedure to establish the diagnosis of ALS. A diagnosis can be established only through a clinical examination and series of diagnostic tests, which rule out other diseases that mimic ALS.
Over 5,600 people in the U.S. are diagnosed with ALS each year. (That's 15 new cases a day.) More people die every year of ALS than of multiple sclerosis or Huntington’s disease. It is estimated that as many as 30,000 Americans have the disease at any given time.
Most people who develop ALS are between the ages of 40 and 70, with an average age of 55 at the time of diagnosis. However, cases of the disease do occur in persons in their twenties and thirties. Generally, ALS occurs in greater percentages as men and women grow older. ALS is 20% more common in men than in women. However with increasing age, the incidence of ALS is more equal between men and women. An elevated incidence of ALS has been observed in military veterans.
Physicians have limited choices for treating ALS, and the options that do exist have come into use within the last 10 years. Studies suggest that patients' length of survival and quality of life are enhanced by night-time breathing assistance early in the course of the disease and by aggressive application of alternate feeding options to assure good nutrition once swallowing becomes difficult.
Costs for medical care, equipment, and home health caregiving can become significant later in the disease. It is important to be knowledgeable about your health plan coverage and other programs for which you may be eligible, including SSA, Medicare, and Veteran Affairs benefits.
The disease and other information on this page is provided for informational and/or educational purposes only and is not meant to diagnose or treat any disease or replace diagnosis or treatment by a medical doctor. Ask your healthcare provider if you have any questions about ALS.