Overview
ALS is a disease of the nervous system that damages motor neurons, the nerve cells that control voluntary muscle movement. As these nerve cells are lost, muscles become weak and smaller from lack of use. Symptoms usually progress over time, but the speed and pattern can vary from person to person.
Key Symptoms
Symptoms often begin with muscle weakness in an arm, hand, leg, or foot, or with changes in speech. People may notice muscle twitching, cramps, stiffness, tripping, dropping objects, slurred speech, or difficulty swallowing. As ALS progresses, breathing muscles can be affected, which may cause shortness of breath or weak cough.
Causes and Risk Factors
The exact cause of ALS is often unknown. A smaller number of cases are linked to inherited gene changes, while most happen without a clear family history. Increasing age is a known risk factor, and researchers continue to study other possible environmental and biological factors.
Who Is Affected
ALS can affect adults in many parts of the world, most often in later adulthood. It is uncommon overall, but it has a major effect on daily function and independence. Some people have a family history of ALS, while many do not.
Diagnosis and Tests
There is no single test that proves ALS. Diagnosis usually involves a neurologic exam, a review of symptoms and medical history, and tests to look for patterns of nerve and muscle damage while ruling out other conditions. These tests may include electromyography, nerve studies, imaging, blood tests, and sometimes genetic testing.
Treatment Categories
Treatment focuses on slowing progression where possible, managing symptoms, and supporting daily life. Care may involve medicines, physical therapy, occupational therapy, speech and language therapy, nutrition support, breathing support, mobility aids, and communication devices. Many people benefit from a team-based approach that includes neurology, rehabilitation, respiratory care, and palliative care.
Living With It
ALS can affect movement, communication, eating, breathing, work, and emotional health. Planning ahead for changing needs can help, including home adjustments, mobility equipment, communication tools, and discussions about future care preferences. Support from caregivers, community services, and patient organizations can be important.
Diet and Lifestyle
Eating enough can become harder if chewing or swallowing is difficult, so nutrition support is often part of care. Gentle activity may help maintain comfort and function for some people, but exercise plans should be individualized by a healthcare professional. Avoiding smoking and getting support for sleep, stress, and daily routines may also help overall well-being.
When to Seek Medical Care
See a healthcare professional if you notice persistent muscle weakness, frequent falls, slurred speech, muscle twitching with worsening weakness, trouble swallowing, or unexplained weight loss. Early assessment is important because several different conditions can cause similar symptoms. New breathing symptoms also need prompt medical attention.
When It May Be an Emergency
Get urgent medical help right away for severe shortness of breath, choking, blue lips, inability to clear secretions, or sudden major trouble swallowing. These problems can become life-threatening and need immediate assessment. Emergency care is also important if a person becomes very drowsy, confused, or difficult to wake.