Amyotrophic lateral sclerosis

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Central nervous system

Lou Gehrig's disease; ALS; Upper and lower motor neuron disease; Motor neuron disease

There is no known cure for ALS. The first drug treatment for the disease is a medicine called riluzole. Riluzole slows the disease progression and prolongs life.

Treatments to control symptoms are also helpful:

• Baclofen or diazepam may be used to control spasticity that interferes with daily activities.
• Trihexyphenidyl or amitriptyline may be prescribed for people with problems swallowing their own saliva.

Physical therapy, rehabilitation, use of braces or a wheelchair, or other orthopedic measures may be needed to maximize muscle function and general health.

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Choking is common. Patients may decide to have a tube placed into their stomach for feeding. This is called a gastrostomy.

A nutritionist is very important. Patients with ALS tend to lose weight. The illness itself increases the need for food and calories. At the same time, problems with swallowing make it hard to eat enough.

Breathing devices include machines that are used only at night, and constant mechanical ventilation.

Patients should discuss their wishes regarding artificial ventilation with their families and doctors.

Emotional support is vital in coping with the disorder, because mental functioning is not affected. Groups such as the ALS Association may be available to help people who are coping with the disorder.

Support for people who are caring for someone with ALS is also available, and may be very helpful.

See: ALS - support group

Over time, people with ALS progressively lose the ability to function and care for themselves. Death often occurs within 3 - 5 years of diagnosis. About 25% of patients survive for more than 5 years after diagnosis.

• Breathing in food or fluid (aspiration)
• Loss of ability to care for self
• Lung failure (See: Adult respiratory distress syndrome)
• Pneumonia
• Pressure sores
• Weight loss

Call your health care provider if:

• You have symptoms of ALS, particularly if you have a family history of the disorder
• You or someone else has been diagnosed with ALS and symptoms get worse or new symptoms develop

Increased difficulty swallowing, difficulty breathing, and episodes of apnea are symptoms that require immediate attention.

Review Date: 08/27/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).