Diagnosis & Treatment

Diagnosis

Amyotrophic Lateral Sclerosis diagnostics are not definitive and are primarily based on symptoms. A test that can be used to support the diagnosis is called electromyography (EMG). This technique allows for detection of the electrical activity in muscles. Also, a MRI (magnetic resonance imaging) can be conducted. This is a test that uses a magnetic field and radio waves to take detailed images of the brain and spinal cord. Other neurological examinations, such as X-rays, blood or urine evaluations, and nerve or muscle biopsies (microscopical examination of body tissue), can be used to help support the diagnosis of Amyotrophic Lateral Sclerosis. ALS is usually concluded twelve months after symptoms begin to present themselves. The most commonly noticed symptoms include muscle weakness and atrophying, hyperreflexia or over responsive reflexes, and spasticity.

ALS Brain vs. Normal Brain

(Fox, Michael D., and Adam B. Cohen. Brain MRI – “Bright Tongue Sign” in ALS. Digital image. Neurology. AAN Enterprises, 02 Oct. 2012. Web. 3 Dec. 2012. <http://www.neurology.org/content/79/14/1520.full&gt;.)

Testing for ALS is still incredibly inaccurate. Many cases of ALS have been and still are misdiagnosed with lyme disease, infectious diseases, or other degenerative diseases. On the contrary, others are diagnosed with Lou Gehrig’s disease by mistake, when ALS is actually not the cause of their symptoms. Thus, testing is only a partially effective determination of whether one has the disease or not.

(JAAPA. Diagnosing ALS. Digital image. JAAPA. American Academy of Physician Assistants and Haymarket Media, 01 July 2006. Web. 6 Dec. 2012. <http://www.jaapa.com/misdiagnosis-and-missed-diagnoses-in-patients-with-als/article/140950/3/&gt;.)

Treatment

Amyotrophic Lateral Sclerosis cannot be cured, halted, or reversed, but research is underway to find medicines that help control symptoms. As of the research done thus far, the only effective treatment to reduce symptoms and increase life expectancy is a FDA approved drug called Rilutek (riluzole). Riluzole prevents damage from overexcitement of glutamate in nerve cells. This is an antiglutamatergic drug, meaning it regulates the release of glutamate, inhibits the voltage-sensitive channels, and regulates the postsynaptic receptor activation at the end of the neuron. This drug has been shown, though inconclusively, to decrease the levels of excitatory amino acids in later stages of ALS. Based on scientific studies, this drug has showed only a three month improvement of survival for ALS patients. Therefore, it only increases life span and does not effectively halt the progression of Lou Gehrig’s disease.

Riluzole

(Rilutek. Digital image. Buy Rilutek Online. Planet Drugs Direct, n.d. Web. 6 Dec. 2012. <http://www.planetdrugsdirect.com/Drugs/Rilutek/101290/&gt;.)

There are mechanical devices, e.g. a ventilator for patients who have troubles breathing or wheelchairs for those unable to walk, that can help to compensate with tasks that become difficult over time for ALS patients. Therapy can help with physical health and ability through bettering circulation and prolonging muscle presence in more early stages. Other medication and supplements can be ingested to help with symptoms in order to maintain independence. Baclofen can relieve pain and stiffness in a patient’s throat and limbs and BCAAs (branched-chain amino acids) can help to slow down atrophy and weight loss. Stem cell therapy is one choice future ALS patients will have, yet this therapy is not ready for use due to the necessity for safety assessments to be conducted. There are multiple other forms of conventional medicine and therapy that have made living with the disease easier through supportive experimentation.

The failure to have antioxidant defense in one’s body can lead to the excitotoxicity, or the damage of neurons due to excessive stimulation of glutamate receptors. Increasing antioxidant and coenzyme levels can combat Amyotrophic Lateral Sclerosis on many fronts. Oxidative stress can be relieved enough to allow cellular calcium levels to decrease slightly. Antioxidants and coenzymes can also support healthy muscle function, helping to compensate for the effects of ALS.