ALS - When Neurons Start to Go!

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Neurodegenerative disease refers to those entities that affect the neurons of the brain or nervous system. These differ from strokes that generally refer to problems with blood delivery to a target area. The most common one known to us is Alzheimer’s disease. The tragedy of the lesser known ones is that they tend to strike at the prime of life. Amyotrophic Lateral Sclerosis (ALS) is one such disease. It is a neurological disorder that causes a slow progression to complete disability. In more than ninety percent of ALS cases, the cause is unknown or thought to be sporadic. A genetic link has been detected in a small percent of cases. ALS becomes critical when the nerves controlling respiration become so affected that the ability to breath becomes severely compromised. The incidence of ALS is on a slow increase for unclear reasons. A small cluster of cases was found in Gulf War Veterans suggesting that toxins and environment are factors. High fat diets and smoking also increase your risks. Fat tends to grab and hold toxins.

Symptoms are very vague at first and can affect any part of the body. Subtle muscle weakness, difficulty swallowing and fatigue are seen more often. Mild breathing problems, difficulty writing or shoulder pain are also seen. When seen in older folks and they begin to have problems with speech or swallowing, they often may be diagnosed with a stroke. Only perseverance, time and extensive testing will point to the right diagnosis. When speech and swallowing is affected patients tend to loose weight and often mislead us into looking for hidden causes such as cancers. The key to diagnosis is careful recurrent observation and should be performed by the same physician. Sometimes, impatience and frustration send patients on a whirl-wind tour of walk-in clinics and emergency departments. The results may conflict and delay the true diagnosis from being made. The diagnosis of ALS involves cat-scans, MRI, EMG’s, breathing tests, repeated blood work, etc. In our system this takes time, and simply arranging the testing can take months.

At this time, there is no effective cure for ALS. Treatments are specific to help control the various symptoms. When symptoms progress, some patients wind up in hospital because they require a ventilator. One of the greatest fears felt by patients afflicted with ALS is the fear of choking to death. Therefore a strong supportive environment is a key element in achieving long term survival.

On another note, I just finished reading the “The China Wall” A new release and inspiring autobiography of that famous Leaf net-minder, Mr. Johnny Bower who just celebrated his 82nd birthday. Happy Birthday Mr. B. and God Blessings! Great reading for Leaf fans and available in book stores for Christmas.

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