Amyotrophic Lateral Sclerosis (ALS)

‘Amyotrophic’ means that the muscles have no nourishment. ‘Lateral’ means that the disease is affecting the sides of the spinal cord where nerves are located and ‘sclerosis’ means hardening or scarring of the tissue. In short, amyotrophic lateral sclerosis is known as ALS that occurs in 1 to 3 people per every 100,000 population.
Amyotrophic lateral sclerosis is also known as Lou Gehrig’s disease which is named after the famous base ball player Lou Gehrig who was diagnosed with it in the year 1939 AD. This disease is a neurological disease that causes weakness of the muscle, disability, and ultimately death of the individual.

Understanding ALS

The nerve cells that help in passing the messages from the brain to the different muscles of the body are known as motor neurons. These motor neurons are present in the brain, brain stem and the spinal cord. The motor neurons in the brain are known as upper motor neurons, while the ones in the spinal cord are known as lower motor neurons. In amyotrophic lateral sclerosis, the upper and lower motor neurons degenerate and die, due to which the messages from the brain is unable to reach the muscles, resulting in loss of function of the muscles.

Genetic mutations are postulated as a cause of genetically inheritable amyotrophic lateral sclerosis. Higher levels of chemical messenger known as glutamate are found in the brain or spinal cord in people suffering from Amyotrophic lateral sclerosis. If a person’s immune system attacks his or her own body cells, then also, it may result in amyotrophic lateral sclerosis. Another cause of the disease can be accumulation of abnormal proteins in the cells which results in the death of nerve cells.


Amyotrophic lateral sclerosis may cause weakness in the feet, legs, ankles, and hand. The affected person may find it difficult to lift the front part of toes and feet. This condition is known as foot drop. There will be muscle cramps and twitching in the shoulders, arms and tongue. The disease usually starts in the hands and feet, and spreads gradually to other parts of the body resulting in paralysis. The affected person may find it difficult to swallow, chew, breathe, and speak.


A detailed medical history is taken by the doctor and a complete physical examination is done. Early diagnosis of amyotrophic lateral sclerosis may be difficult as it can appear to be like nerve compression, multiple sclerosis and spinal cord tumors. Tests like electromyogram and nerve conduction velocity are conducted on the muscles and nerves. To rule out other diseases, MRI scan, CT scan and testing of spinal fluid is done.


The disease is not curable, but the symptoms can be managed, and the progression of the disease can be slowed.

  • The only medication approved by the Food And Drug Administration for slowing the disease progression and lowering the levels of glutamate is riluzole (Rilutek).
  • The doctor may also prescribe medications to provide relief from constipation, muscle cramps, excessive salivation, excessive phlegm, depression, pain and fatigue.
  • To improve the muscle strength, improve motion and for cardiovascular fitness, physical therapy with low impact exercises is recommended.
  • In occupational therapy, the use of wheel chair, walker, ramps or braces is advised to help the person get around.
  • Since speech is affected due to the disease, a speech therapist helps the person speak by using adaptive speech techniques.
  • Alternative method of communication like writing is also explored.
  • Use of speech synthesizers and computer based equipment is also used.

Beating ALS

According to the ALS association, 50% of the people suffering from the disease will survive only 3 years after diagnosis and 20 % make it up to 5 years while 10 % live for 10 years. But beating all the odds, is the world famous physicist who baffled the world with his understanding of the universe, Stephen Hawking who has survived ALS for more than 40 years now. Stephen has written a number of best sellers from his wheel chair for more than 20 years. He uses a voice synthesizer and computer to speak and write. Stephen Hawking has a wife and three children, and he says that living with ALS could not prevent him from having a lovely family and taste success in his work, and one who has ALS should never lose hope. He is a living example of hope and inspiration to all those who are having ALS.