Lou Gehrig’s disease or amyotrophic lateral sclerosis (ALS) is a motor neuron disease, diagnosed by experts such as Internal Medicine Specialists in Islamabad, which affects the brain and the spinal cord. Once diagnosed, this disease progresses over time, causing a number of symptoms. Read on to know more about Lou Gehrig’s disease or amyotrophic lateral sclerosis:

What is Lou Gehrig’s disease?

The neuromuscular disease that causes loss of muscle control and affects the neurons in the brain and the spinal cord is called Lou Gehrig’s disease or amyotrophic lateral sclerosis. This disease often begins with weakness and twitching of limbs and progresses to cause muscle paralysis, making movement, speech and even breathing difficulty. 

In Lou Gehrig’s disease, the motor neurons, which are the cells controlling movement and ‘motor function’ slowly die off. Consequently, the muscles controlled by these neurons also waste away. The sensory functions, however, along with the mental faculties remain unaffected. 

Lou Gehrig’s disease has no known cause or cure. Most of the management options are symptomatic, which is why Lou Gehrig’s disease is fatal, with average life expectancy of two to five years after diagnosis. In exceptional cases, the patients survive for decades. 

As mentioned before, the exact cause of Lou Gehrig’s disease is not known. It is postulated that exposure to toxins, infectious agents, poor diet, physical trauma and occupational factors play a role in the spontaneous development of disease. Additionally, more than a dozen genetic factors have been identified that play role in the disease etiology. 

What are the symptoms of Lou Gehrig’s disease?

Depending on which neurons are affected, the symptoms of Lou Gehrig’s disease vary from person-to-person. In general, the disease begins as muscle weakness which gets worse with time. The signs and symptoms of this disease include:

• Tiredness and weakness in the muscles
• Falling and tripping
• Difficulty in performing activities of daily living 
• Cramps in the muscles 
• Twitching in the arms, shoulder or legs 
• Stiff muscles (spastic paralysis)
• Difficulty in chewing and swallowing 
• Weakness in the muscles of tongue thereby causing slowed or slurred speech 
• Difficulty in projecting voice 
• Breathing difficulty 
• Eventually individuals are unable to walk or even stand on their own. 
• Weight loss 
• Anxiety and depression 

Who is at risk of Lou Gehrig’s disease?

Around the world, more than 0.1 million cases of this disease get diagnosed every year. The risk factors include:

• Age of the patient between 55 and 75 years. 
• Caucasians, in comparison to other races, get diagnosed more often. 
• In the earlier age, men are at higher risk, while in older individuals the risk is equal between both genders.  
• Positive family history also predisposes one to Lou Gehrig’s disease. 

How is Lou Gehrig’s disease diagnosed?

The diagnosis of Lou Gehrig’s disease is based on history and examination, along with muscle and neurological investigations at regular intervals. These investigations include:

• Electromyography (EMG): this technique detects the electrical activity of the muscles and is one of the confirmatory tests for Lou Gehrig’s disease.
• Nerve conduction studies: this investigation measures the electrical activity of the nerves, and the ability of the nerves to send signals to the muscles. Along with EMG studies, this is an important investigation for ALS diagnosis. 
• Muscle biopsy: another important investigation for Lou Gehrig’s diagnosis is muscle biopsy to check if the patient has a muscle disease other than ALS. This test is performed by taking a sample of muscle under local anesthesia and sending to the lab for analysis. 
• Magnetic resonance imaging: this investigation uses magnetic waves to make detailed images of the brain and spinal cord. 
• Blood and urine tests: are also performed to evaluate the overall health of the patient and rule out other diseases. 
• Spinal fluid test: is performed to help support the diagnosis of Lou Gehrig’s disease. 

After initial diagnosis, many healthcare providers recommend getting a second opinion from a reputable hospital like Fatima Memorial Hospital.