Amyotrophic lateral sclerosis

"The ALS patient maintains his or her intellectual capacity intact and is aware of the progressive progression of the disease. The adaptation of the patient and his family to this disabling process requires the professional support of a multidisciplinary team".

DR. JAIME GÁLLEGO
SPECIALIST. NEUROLOGY DEPARTMENT

Amyotrophic lateral sclerosis or ALS belongs to a group of diseases called motor neuron diseases. Motor neurons degenerate or die and stop sending messages to the muscles. Unable to function, the muscles gradually weaken and wear out (atrophy) and contract (twitching).

It is characterized by a progressive atrophy of all the muscles of the body except the heart and the muscle that controls the motility of the eyes and the sphincters (bladder and anal), without producing alterations of the sensibility.

The disease produces a degeneration of the motor neurons of the brain and spinal cord, but the cause of this degeneration is unknown.

There are familiar forms of the disease in approximately 5 to 10% of cases.

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What are the symptoms of ALS?

Characteristically, it produces loss of strength and muscular atrophy that generally begins in one hand or leg, later affecting the rest of the extremities. It is frequent that the patients observe small contractions of some parts of their musculature (fasciculations) or painful cramps with the movements.

The disease can also produce difficulty in swallowing (dysphagia), pronouncing some words (dysarthria) or breathing normally (dyspnea). The progression of the disease is usually irregular, that is, asymmetrical (the disease progresses differently in each part of the body). Sometimes the progression is very slow, developing over the years and having periods of stability with a variable degree of disability.

At no time are the intellectual faculties affected, nor are the sense organs (hearing, sight, taste or smell), nor are the sphincters or sexual function affected.

The disease cures without pain although the presence of cramps and the loss of the mobility and muscular function bring certain malaise. In some cases, symptoms related to alterations of the affectivity appear (crying, inappropriate laughs or, in general, disproportionate emotional answers as reaction to the physical affectation).

The most common symptoms are:

  • Loss of strength.
  • Muscle atrophy.
  • Muscle contractions.
  • Cramps.

Do you have any of these symptoms?

You may have amyotrophic lateral sclerosis

How is ALS diagnosed?

<p>Resonancia magn&eacute;tica</p>

The diagnosis is made based on the patient's symptomatology and with the help of a scan called electromyography.

There are many diseases whose symptoms are similar to those observed in ALS such as cervical osteoarthritis or cervical hernias that compress the spinal cord, heavy metal poisoning (lead for example), some infectious diseases such as borreliosis and syphilis, tumors, hyperthyroidism, etc.

Sometimes it is necessary to rule out these diseases with blood or cerebrospinal fluid tests (lumbar puncture) and cerebral and cervical magnetic resonance.

Exceptionally, and if doubts persist about the diagnosis of this disease, a muscle biopsy is required to confirm it.

How is amyotrophic lateral sclerosis treated?

ALS is a progressive disease that has no cure, although some drugs have proven effective in slowing its progression (such as riluzole).

Patients can benefit from physical therapy to avoid complications from muscle weakness and bedding and from different drugs when there is pain, muscle cramps, constipation, insomnia or depression.

When there are communication problems due to pronunciation difficulties, the help of speech therapists or the use of devices such as voice amplifiers or communicators is very useful.

The adaptation of the patient and his/her family to this disabling process requires the professional support of a multidisciplinary team (doctors, psychologists, social workers, physical and occupational therapists, among others) that allows the best possible management of the complications of the disease.

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Neurology
of the Clínica Universidad de Navarra

The Neurology Department has extensive experience in the diagnosis and multidisciplinary treatment of neurological diseases.

We offer a diagnosis in less than 72 hours, along with a proposal for personalized treatment and post-consultation follow-up of the patient by our specialized nursing team.

We have the most advanced technology for an accurate diagnosis with cutting-edge equipment such as HIFU, deep brain stimulation devices, video EEG, PET and epilepsy surgery, among others.

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