Lou Gehrig's disease

Lou Gehrig's disease, often called as Amyotrophic Lateral Sclerosis (ALS), is a progressive degenerative disorder that affects the brain and spinal cord. Consequently, the patient loses control over the voluntary muscles. The most commonly affected nerves include those controlling the limb movements, speech, and swallowing.

The disease is named after a famous baseball player, Lou Gehrig who was diagnosed with the condition in 1939. In 2014, several famous personalities including Justin Bieber, Usain Bolt, etc. have participated in the ice bucket challenge to promote awareness of amyotrophic lateral sclerosis.


The Lou Gehrig's disease symptoms which are produced in the initial stages include:

  • weakness or stiffness of the muscles in a particular area (spasticity)
  • difficulty chewing or swallowing
  • slurred and nasal speech

If the disease starts in the limbs, the patient will have difficulty with writing or buttoning a shirt, or will have a tripping or stumbling feel while walking or running.

As the disease progresses, the weakness spreads to the entire body. Eventually, the patients lose their ability to walk or even stand, use their hands and arms.


Complications which occur with the disease progression are as detailed below:

Eating problems: Malnutrition and dehydration can develop overtime due to difficulty with swallowing. Pneumonia can also occur due to the entry of food, and drinks into the lungs.
The difficulty with speech: This may include severe slurring of speech and makes it difficult for others to understand what you express.
Breathing difficulty: In more advanced stages, the condition can also affect the nerves that control breathing and other vital functions, and may lead to the death of the patient.
Cognitive impairment: Some individuals with ALS may have difficulties with cognitive abilities such as memory or decision-making.

Coping and support

As ALS is a devastating condition, it can be difficult for the person to cope up with the family and friends. But certain tips can be of help for such patients:

  • Be hopeful about your team who treat you to improve your quality of life
  • Think beyond; do not think that having ALS is your entire identity of life
  • Make decisions about your future medical plan
  • Join a support group which provides extra care and where you can share your feelings


The exact cause is not known in most of the patients (sporadic), however, the ALS disease is believed to be caused due to mutations in the genes associated with the production of an enzyme called SOD1. As a result, the enzyme becomes toxic.

The other possible contributing causes of ALS include:

  • free radical damage
  • abnormally high levels of a chemical messenger called glutamate
  • an immune response that targets motor neurons
  • accumulation of abnormal proteins inside nerve cells

Risk factors

The following factors are identified to increase the risk of a person getting ALS:

  • Smoking
  • Exposure to lead
  • Military service (possibly due to traumatic injuries, exposure to certain chemicals or metals, viral infections, and intense exertion)
  • Family history

Usually, the symptoms occur in people aged 50 to 60. However, it can also occur in early ages. Men have a slightly higher chance of getting ALS compared to women.

The diagnosis of ALS can take from weeks to months. Initially, your doctor may suspect that you have ALS if you show a progressive neuromuscular decline. Then the doctor will look for symptoms such as muscle weakness, wasting, twitching, and cramps. However, these symptoms may be present in other conditions. Therefore, a series of one or more of the following diagnostic tests are performed to rule out the other conditions and confirm ALS.

Test type Purpose of the test
Blood and urine tests To evaluate your general health and nutrition
EMG (Electromyogram) To evaluate the electrical activity of the muscles
MRI (Magnetic resonance imaging) To identify which parts of the nervous system are affected
Nerve conduction studies To test the nerve function
Muscle biopsy To rule of muscle diseases
Genetic tests May be performed if a family history of ALS is present

Unfortunately, no treatment so far is available to cure Lou Gehrig disease. Treatments focus on slowing down the disease progression and help you to lead an independent life.

Medications: The only drug approved for treating ALS is riluzole. It reduces the production of glutamate.

The other drugs prescribed for symptomatic treatment include those for:

  • Pain
  • Muscle cramps and spasms
  • Constipation
  • Excessive salivation
  • Depression
  • Uncontrolled outbursts of laughing or crying
  • Sleep problems

The other therapies employed in the treatment of ALS are:

Nutritional support: Your family members will be instructed on how to meet your nutritional requirements and help you with swallowing difficulty.
Breathing devices: They are used in the advanced stages, to assist breathing during your sleep.
Physical therapy:You will be trained on stretching and certain low-impact exercises to maintain the muscle strength, cardiovascular health, etc. so that you can stay independent.
Speech therapy: You will be taught some adaptive techniques which can help you to communicate better.
Psychological and social support: A team of members is involved in providing, psychological, emotional and financial support to you.