Amyotrophic Lateral Sclerosis

Alternative names:

ALS; Lou Gehrig's disease

Symptoms:

• muscle weakness, decrease in muscle strength and coordination
  • affecting the shoulder and upper arm or the hips and upper thigh
  • gradual onset
  • progressively worsens
  • commonly involves 1 limb (such as the hand)
  • progresses to difficulty lifting, climbing stairs, and so on

• possible paralysis
• muscle cramps
• voice changes, hoarseness
• speech impairment, slow or abnormal speech pattern
• difficulty swallowing, gags or chokes easily
• difficulty breathing (increasing effort required to breathe)

Additional symptoms that may be associated with this disease:

• urinary frequency/urgency, increased
• muscle contractions
• muscle atrophy
• ankle, feet, and leg swelling

Signs and tests:

Neuromuscular examination indicates weakness, often beginning in 1 limb or in proximal groups (shoulders, hips). There may be muscle tremors, spasms, fasciculation (twitching) or muscle atrophy (loss of tissue). The gait may be stiff or clumsy. Reflexes may be abnormal, including loss of the gag reflex. "Emotional incontinence" (loss of bladder control during strong emotional stimulation) is possible.

• An EMG indicates loss of muscle function caused by lack of nervous stimulation.
• Head CT or MRI of head may be abnormal (but these tests are not usually required to diagnose this disorder).

This disease may also alter the results of an acetylcholine receptor antibody test: