ALS: The Classic Medical Perspective

EPISODE TITLE: ALS: The Classic Medical Perspective

EPISODE SUMMARY: In this episode of NOGGINS & NEURONS: Brain Injury Recovery Simplified, Doro and Deb talk about Amyotrophic Lateral Sclerosis (ALS) or, Lou Gehrig’s Disease. We covered:

• What is ALS?
• Signs & symptoms of ALS including:
  • Affects voluntary muscles-hands, forearms, legs.
• Early symptoms include:
  • Fasciculations- spontaneous, uncontrolled discharges of motor neurons; irregular twitchings: Muscle twitches in the arm, leg, shoulder, or tongue
  • Muscle cramps
  • Tight and stiff muscles (spasticity)
  • Muscle weakness affecting an arm, a leg, or the neck
  • Slurred and nasal speech
  • Difficulty chewing or swallowing
  • Difficulty walking, picking up objects, fine motor tasks
• Ongoing/Later symptoms:
• Chewing food and swallowing (dysphagia)
• Drooling (sialorrhea)
• Speaking or forming words (dysarthria)
• Breathing (dyspnea)
• Unintended crying, laughing, or other emotional displays (pseudobulbar symptoms)
• Constipation
• Maintaining weight and getting enough nutrients
• Frontotemporal dementia
  • Dementia that affects the frontotemporal lobe.
  • Affects thinking, talking, walking, and socializing.
  • FTD and other frontotemporal disorders are a common cause of early-onset dementia, often appearing when people are in the prime of life.

• • • Families often suffer, as they struggle to cope with the person's daily needs as well as changes in relationships and responsibilities.

• Risk Factors (National Institute of Neurological Disorders & Stroke)-Having a risk factor does not mean a person will or will not get a disease

• • Age—Although the disease can strike at any age, symptoms most commonly develop between the ages of 55 and 75.
  • Biological sex—Men are slightly more likely to develop ALS than women. However, at older ages, men and women are equally likely to be diagnosed with ALS.
  • Race and ethnicity—Whites and non-Hispanics are most likely to develop the disease, but ALS affects people of all races and ethnic backgrounds.

• National Institute of Neurological Disorders & Stroke/ALS.org
• Some studies suggest military veterans are about one and a half to two times more likely to develop ALS, although the reason for this is unclear. Possible risk factors for veterans include exposure to lead, pesticides, and other environmental toxins. Some studies have also shown that head injury can be associated with higher risk for ALS, but more research is needed to understand this connection.
• For about 90% of all cases, there’s no known family history of the disease or presence of a genetic mutation linked to ALS.
• For 5-10% of all cases, there’s a known family history of the disease. This is often called familial ALS.

      ALS.org

• In families with familial ALS, there is a 50% chance each offspring will inherit the gene mutation and may develop the disease.
• Medical treatment-involves medications
• Common PT & OT interventions
  • Assistive technology & Communication devices
    • OBI – independence with feeding
    • Battery-operated salt & pepper shakers
    • Steady spoon if tremors are present
    • Built up handle utensils
    • Eazy Hold grip aids
    • Universal cuff
    • Divided Dish