Amyotrophic Lateral Sclerosis
(ALS; Lou Gehrig's Disease; Motor Neuron Disease)
by Rosalyn Carson-DeWitt, MD
Amyotrophic lateral sclerosis (ALS) is a progressive nervous system disorder. It gradually destroys the nerves responsible for muscle movement. Over time, ALS leads to almost total paralysis of muscle movement, including breathing. Eventually, the disorder leads to respiratory failure.
The cause of ALS is unknown. Genes may play a role.
Risk Factors TOP
Factors that may increase your risk of getting ALS include:
Symptoms of ALS include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. There are no tests that can diagnose ALS. Tests may be used to rule out other medical conditions.
Images may be taken of your bodily structures. This can be done with:
Your bodily fluids and tissues may be tested. This can be done with:
Your muscles and nerves may be evaluated. This can be done with electromyogram (EMG)/nerve conduction velocities (NCV).
Your cognitive skills may be assessed. This can be done with neuropsychological testing.
There is currently no cure for ALS.
Treatment may help to reduce or manage symptoms for a time. A combination of treatments may work best. This may include:
Treatment options include:
The drug riluzole has been approved for ALS. The drug may slightly improve functioning, but it does not stop the disease from progressing.
Your doctor may prescribe these medicines for symptoms:
Other Types of Treatments
Supportive care may be needed as ALS progresses, including:
There are no guidelines for preventing ALS because the cause is unknown.
National Institute of Neurological Disorders and Stroke
ALS Society of British Columbia
ALS Society of Canada
Aggarwal, SP, Zinman L, Simpson E, et al. Clinical trial testing lithium in ALS terminates early for futility. Lancet Neurol. 2010; 9(5): 481-488.
Amyotrophic lateral sclerosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 8, 2013. Accessed May 21, 2013.
Amyotrophic lateral sclerosis fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.n.... Updated May 15, 2013. Accessed May 21, 2013.
Sathasivam S. Managing patients with amyotrophic lateral sclerosis. Eur J Intern Med. 2009;24:355-358.
Walling AD. Amyotrophic lateral sclerosis: Lou Gehrig's disease. Am Fam Physician. 1999;59:1489-1496.
4/17/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Fornai F, Longone P, Cafaro L, et al. Lithium delays progression of amyotrophic lateral sclerosis. Proc Natl Acad Sci USA. 2008;105:2052-2057.
1/14/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Mateen FJ, Carone M, Sorenson EJ. Patients who survive 5 years or more with ALS in Olmsted County, 1925-2004. J Neurol Neurosurg Psychiatry. 2010;81(10):1144-1146.
Last reviewed May 2013 by Rimas Lukas, MD; Michael Woods, MD
Last Updated: 5/21/2013