Amyotrophic lateral sclerosis (ALS) is a nervous system disorder that worsens over time. It affects nerves in the brain and spine that are responsible for muscle movement. The nerves gradually die, which can lead to almost total paralysis, including being unable to breathe. ALS is fatal, often due to respiratory failure.
You will be asked about your symptoms and medical history. A physical exam will be done. There are no tests that can specifically diagnose ALS. Instead, tests will be done to rule out other medical conditions.
Imaging tests to look for changes in the brain or spine may include:
There is currently no cure for ALS. A combination of treatments may help to reduce or manage symptoms.
Treatment options include:
and edaravone have been approved for ALS. The drugs may slightly improve functioning, but it does not stop the disease from progressing.
Medications may include:
Muscle relaxants to help muscles that are in spasm
Nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain medications
Medication to reduce heavy drooling
Antidepressants and anti-anxiety drugs
Medication to treat inappropriate laughter or crying
Other Types of Treatments
Supportive care may be needed as ALS progresses, including:
Physical therapy—To reduce pain associated with muscle cramping and spasticity
Respiratory care—In some cases, extra oxygen may be needed or a machine may be needed to help with breathing.
will be eventually needed to make an artificial airway that bypasses the throat.
Nutritional care—Swallowing will eventually be lost. Nutrition will need to be delivered through
Speech therapy—Speech therapy may help improve communication. This will not only include working with speech when possible, but also finding other ways to communicate when speech is no longer possible.
Amyotrophic lateral sclerosis (ALS) fact sheet.
National Institute of Neurological Disorders and Stroke website. Available at:
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Amyotrophic-Lateral-Sclerosis-ALS-Fact-Sheet. Updated January 8, 2018. Accessed February 21, 2018.
Sathasivam S. Managing patients with amyotrophic lateral sclerosis.
Eur J Intern Med.