What is ALS?
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurological disorder affecting motor neurons, which are nerve cells in the spinal cord that control voluntary muscle movements. ALS disrupts communication between these motor neurons and muscles, causing damage and making it increasingly harder for muscles to function. Over time, this leads to loss of movement and muscle control.
ALS is considered rare, affecting about 9 in every 100,000 people in the US. Each year, approximately 5,000 new cases are diagnosed, according to the Centers for Disease Control and Prevention (CDC). While ALS can develop at any age, it most often begins between 50 and 75 and is more common in men than women.
There is no cure for ALS yet, but treatments can help manage symptoms, slow its progression and improve quality of life.
ALS symptoms
ALS symptoms can vary from person to person, depending on which nerve cells are affected. Early signs of ALS may include:
- Muscle twitches in the arms, legs, shoulders or tongue
- Muscle cramps
- Stiff or tight muscles (spasticity)
- Weakness in an arm, leg or the neck
- Slurred speech or a nasal-sounding voice
- Trouble chewing or swallowing
As the condition progresses, muscle weakness spreads and can make daily activities more difficult. People with ALS may experience:
- Trouble chewing and swallowing food (dysphagia)
- Excess saliva or drooling (sialorrhea)
- Difficulty speaking clearly (dysarthria)
- Shortness of breath (dyspnea)
- Sudden, uncontrollable laughing or crying
- Constipation
- Trouble maintaining weight and getting enough nutrients
Over time, ALS affects movement more severely, making it impossible to walk, use the hands and arms or breathe without assistance. Most people maintain clear thinking and memory, but some may experience mild to moderate difficulties with language, decision-making or managing emotions, which can add emotional strain for people and their families.
When to see a doctor
See your primary care provider if you develop ALS-like symptoms, especially if a parent or someone else in your family has the condition. Your provider will refer you to a neurologist if they suspect ALS. A neurologist can confirm the diagnosis and coordinate with a team of other providers to deliver well-rounded care.
What causes ALS?
The exact cause of ALS remains largely unknown. The most common form, sporadic ALS, usually develops without a clear reason, and scientists are still working to understand the underlying causes. A smaller percentage of cases—about 5% to 10%—are classified as familial ALS, which is caused by inherited genetic mutations. In some instances, genetic changes may also contribute to sporadic ALS, even in the absence of a family history of the condition.
In addition to genetics, environmental factors may also play a role in the development of ALS.
Most cases of ALS appear to result from a complex interaction between genetic predispositions and environmental influences. Researchers continue to study these potential triggers in hopes of finding ways to prevent or slow the progression of ALS.
ALS risk factors
While the exact cause of ALS isn’t fully understood, certain factors can increase the likelihood of developing the condition. These include:
- Age: ALS is very rare in people under 40, but the risk increases as you get older, especially between 50 and 75.
- Sex: Men are more likely to develop ALS than women, though this difference tends to even out after age 70.
- Genetics: In some cases, ALS runs in families due to inherited gene changes.
- Lifestyle factors: Smoking is a known risk factor and can increase the chances of developing ALS.
- Work-related factors: Certain jobs, like being in the military or working as a welder, may increase the risk due to injuries or exposure to harmful substances.
- Environmental factors: Exposure to chemicals or heavy metals like lead and pesticides may also raise the risk of ALS.
Knowing these risk factors can help you understand your own chances of developing ALS, but it’s important to remember that having one or more of these factors doesn’t mean you will get the disease. Many people with risk factors never get ALS, and some people without any known risk factors do develop it.
If you're concerned about your risk—especially if you have symptoms or a family history of ALS—talking to your doctor is the best way to get personalized guidance and support. Your healthcare provider can help you better understand your individual risk and any steps you can take to protect your health.
Complications
As ALS progresses, muscle weakness and loss can lead to various complications that impact your life—including your physical and mental health, independence and mobility. While these changes can be challenging, working closely with your medical team, caregivers and loved ones can help you navigate complications and get the support you need.
Here are some potential complications of ALS:
- Aspiration: Difficulty swallowing can cause food or liquid to enter your airway and reach your lungs.
- Depression and anxiety: The emotional toll of ALS may lead to feelings of sadness, stress or being overwhelmed.
- Loss of independence: As daily tasks like eating, dressing and bathing become harder, you may need assistance from a caregiver.
- Pneumonia: If food or liquid enters your lungs, it can increase the risk of developing pneumonia.
- Pressure sores: Prolonged sitting or lying down may irritate your skin, leading to sores.
- Respiratory failure: Weakening respiratory muscles can make breathing difficult, and eventually, you may need assistance.
- Weight loss: Chewing and swallowing difficulties, along with a reduced appetite, can make it hard to maintain weight.
While these complications can be overwhelming, planning ahead and seeking medical and emotional support can help you manage symptoms and maintain the best quality of life possible.
How is ALS diagnosed?
Diagnosing ALS can be challenging because no single test can confirm the condition. Instead, healthcare providers rely on a thorough clinical examination and a series of diagnostic tests to rule out other conditions that mimic ALS before making a diagnosis. To get a clear picture of what’s happening, your doctor may recommend one or more of the following tests.
Amyotrophic lateral sclerosis treatment
While there’s no cure for ALS, treatment can help slow the condition, manage symptoms and improve your quality of life.
Caring for ALS takes a team. Your neurologist, primary care doctor and specialists—such as physical therapists, speech therapists and dietitians—will work together to support you. They may recommend medications to slow the disease, therapies to help you stay active and supportive care for breathing, eating and daily tasks.
Although ALS is a challenging condition, the right care and support can help you maintain independence and live as fully as possible.
Find specialized ALS care near you
If you or a loved one has been diagnosed with ALS, finding the right care and support is essential. Baylor Scott & White offers ALS care at various locations throughout North and Central Texas, providing access to specialized treatments, rehabilitation therapies and support services.
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