Movement Disorders: Amyotrophic Lateral Sclerosis, Essay Example

This disease attacks neurons and muscles (neuromuscular disorder). The elderly are more prone to the disorder than young people are. The risk of getting the disease becomes uncertain beyond 70 years. This is because it becomes hard to differentiate ALS from other conditions at this age and beyond. The disease attacks men more easily as compared to women (Corcia et al, 2010, p. 4). The disorder affects motor neurons present in the cerebral motor cortex, spinal cord, and brain stem causing them to degenerate. Motor neurons refer to nerve cells that enable communication between voluntary muscles of the body and the highest levels of the nervous system. Degeneration of the upper motor neurons causes disruption of the connection of the neurons to the spinal interneurons and the lower motor neurons (Kumar et al, 2010, p.3). Spasticity and weakness of muscles result from the disruption. Muscle atrophy results because of the degeneration of the lower motor neuron disrupting nerve contact with the muscles. Fasciculation, a spontaneous muscle activity occurs and at last, the affected person becomes unable to speak or swallow, unable to move legs and arms. Disruption of connections between muscles and neurons concerned with breathing may lead to patients requiring mechanical ventilation for survival or else die.

The cause of the majority of ALS cases has no known causes. Genetic disorders cause only about 10% of the cases. In the world, the disorder affects about 5/100,000 people (Kumar et al, 2010, p. 6). The symptoms of ALS include difficulty in breathing and swallowing, drooling, gagging choking easily, muscle cramps, head drop, muscle contractions (fasciculation), paralysis (speech problems, hoarseness and weight loss) and muscle weakness. During tests and examination, the medics focus on medical history including endurance and strength.

Tests for ALS

• Testing blood to do away with other conditions;
• MRI or cervical spine CT;
• Test for breathing;
• Carrying out test on genetic influence; and
• Studies on swallowing of food

Current treatment for ALS

Amyotrophic lateral sclerosis is an irreversible disorder. Treatment for amyotrophic lateral sclerosis involves actions aimed at making the victim more independent and comfortable and to slow progression of symptoms (Corcia, P., et al 2010, p.8). In this case, there exist medication and therapy solutions for the ALS disorder.

ALS has no known cure. A drug known as riluzole prolongs life and helps in slowing progression of the disease. Treatment of symptoms involves use of amitriptyline or trihexyphenidyl for swallowing difficulties and diazepam or baclofen in controlling spasticity, which interferes with day-to-day activities.

Therapy treatment includes physical therapy, speech therapy, and occupational therapy. Physical therapy may be in form of exercises of low impact to help in maintaining cardiovascular fitness, strength of the muscles, and make the victim independent. Occupational therapy involves accustoming the patient to a walker, brace or wheelchair. Occupational therapists may also give ramps, which enable the victim get around easily. Speech therapists help ALS patients with speech problems using techniques, which are adaptive so that the victims are able to make clear speech. As the diseases progresses it may be necessary to employ use of computer-based equipment and speech synthesizers to help victims communicate.

Future direction of ALS treatment

Multidisciplinary approach including palliative care will enable optimal ALS management (Bede, 2011, p.85). Both the quality of life and survival of victims improves with a multidisciplinary approach use. Victims with last stage ALS often develop symptoms that are distressing in a short period and therefore effective communication between the primary care physician, multidisciplinary ALS team and the palliative care team. Attempts to predict the disease before its onset help a lot in the management of the disorder (Kumar et al, 2010, p. 2).

References

Bede, P. (2011). Palliative care in amyotrophic lateral sclerosis: A review of current international guidelines and initiatives. Journal of neurology, neurosurgery & psychiatry with practical neurology, Vol. 82, (4), p.77-94.

Corcia, P., De Toffol, B., Guennoc, A., Praline, J., & Vourc’h, P. (2010). Primary lateral sclerosis may occur within familial amyotrophic lateral sclerosis pedigrees. Amyotrophic Lateral Sclerosis, Vol. 1 (1/2), p.154-156.

Kumar, S., Singla, M., &Tyagi, S. (2010). Role of stem-cell therapy in the management of amyotrophic lateral sclerosis, a neurodegenerative disorder: an overview. International Journal of Pharma & Bio Sciences, Vol. 1(2), p.1-11.