21 April

Amyotrophic lateral sclerosis - symptoms, treatment

Contents:

1. Classification ALS

2. clinical picture

3. Complications ALS

4. treatment of amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis(Lou Gehrig's disease, ALS) - a chronic, clinically and genetically heterogeneous, progressive, fatal disease that affects the central and peripheral motor neurons.BAS at the present time is the most frequent of progressive motor neuron diseases, and the most severe from all degenerative diseases of the central nervous system.

etiology of this disease is not clear.Some experts argue that the main role in the occurrence of ALS play viruses, as well as metabolic and immunologic disorders.When it comes to the development of a familial form of the disease Charcot, discusses the role of mutations in the superoxide dismutase-1 gene, 21q22-1 chromosome.

Classification ALS

At the present time there are the following forms of amyotrophic lateral sclerosis:

  • cervicothoracic.
  • Bulbar.
  • Primary-it generalized.
  • lumbosacral.
  • High.

As for the options of the disease, then there are only three:

  • Pyramid (high form of ALS) - primarily affecting the central motor neurons.
  • segmental-core - loss of peripheral motor neurons.
  • Mixed (classical ALS) - even the defeat of the peripheral and central motor neurons.

clinical picture

to the initial symptoms of ALS include:.

  • cramps (muscle cramps, painful cuts, often generalized They are found in virtually every patient in most cases, the symptom is the most.the first sign of ALS
  • weakness and lethargy in the distal hand fastikulyatsii (muscle twitching), weight loss in your hands, awkwardness when performing fine movements of the fingers
  • bulbar disorders -.. dysphagia and dysarthria (25% of patients)
  • weakness... in the shoulder girdle and proximal hand
  • atrophy of the leg muscles, accompanied by lower spastic paraparesis

amyotrophic lateral sclerosis may affect as lower motor neurons, and the top symptoms of the defeat of the lower motor neuron include:. hyporeflexia, muscle weakness, fasciculations andmuscle atrophy.With regard to the destruction of the upper motor neuron, that it is characterized by: spasticity, muscle weakness, abnormal carpal and stopnye signs and hyperreflexia.

In most cases, the disease is characterized by asymmetry of symptoms of Charcot.In the classic version of the illness begins with a weight loss of muscle thenar of one of the brushes.The patient feels difficulty and discomfort when buttoning buttons, at the time of picking up small objects, when writing.

Then, during the progression of the disease, the brush becomes like a "claw" and, in the process of beginning to engage the muscles of the forearm.After a while, there is destruction and other arms.Atrophy is beginning to spread to the muscles of the shoulder and the shoulder girdle.

At the same time, to the aforementioned symptoms of amyotrophic lateral sclerosis joins defeat bulbar muscles (atrophy and fasciculations language, dysphagia, drooling, paresis of the soft palate, dysarthria, and so on.).

chewing and facial muscles are involved in the process, as a rule, a little later.As the disease progresses it becomes impossible to inflate the cheeks, protruding tongue, and lips stretch into a tube.At times there is a weakness of the extensor of the head, which does not allow the patient to keep his head straight.

also in the process may involve the diaphragm, which leads to a paradoxical breathing (inspiratory stomach sinks, as you exhale - bulges).

first on the legs atrophied lateral and anterior muscle group that appears type steppage gait and gait "dangling foot."

Half of patients suffering diminished work capacity and memory.

All of the above symptoms of amyotrophic lateral sclerosis is quite serious, as they daily deliver to patients a lot of trouble and a lot of discomfort.

Complications

ALS Lou Gehrig's disease often leads to the following complications:

  • Depression.
  • Cachexia.
  • Multiple cramps.
  • Urosepsis.
  • limb contractures.
  • Respiratory, as well as respiratory failure.
  • paresis and paralysis of the muscles of the neck and limbs.
  • Dysphagia.
  • Aspiration pneumonia.

progression of movement disorders in a few years has resulted in death.

treatment of amyotrophic lateral sclerosis

Today, effective treatment of amyotrophic lateral sclerosis does not exist.Rilutek - the only drug that can postpone death for a few months.

As a rule, the main therapy for ALS is considered to be symptomatic.It includes:

  • Physical Activity.
  • Physiotherapy.
  • application of orthoses (different tires, cervical collar, for capturing objects device, and so on.).
  • Diet.
  • When salivation prescribe atropine and hyoscine.
  • At cramps - Quinine sulfate, phenytoin, carbamazepine, verapamil, magnesium preparations.
  • When pain syndromes - analgesics, and in the latter stages - narcotic analgesics.
  • When spasticity - tizanidine, baclofen, memantine, clonazepam.

addition, in the treatment of amyotrophic lateral sclerosis using anticholinesterase drugs, Cerebrolysin (very high doses) and antidepressants.

Attention!

This article is available exclusively in the educational purposes and is not research material or professional medical advice.

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