What happens in this disease?
In ALS, the nerve cells that control the muscles die over time in the brain and spinal cord. These cells send movement signals to the muscles. When the signals no longer arrive, the muscles become weak and thin. The disease is progressive and shortens life; but its speed varies greatly from person to person.
Which symptoms can occur?
Symptoms usually begin in adulthood and increase over time.
- Twitching, cramps or stiffness in the muscles (common; among the first symptoms)
- Weakness in the hands, arms or legs (common)
- Slurred speech and difficulty swallowing (common)
- Loss of the ability to walk over time (common)
- Difficulty breathing (as the disease progresses)
- Drooling (sometimes)
- Changes in behavior or personality, called frontotemporal dementia (sometimes)
How is it diagnosed?
For the diagnosis, the person is referred to a neurologist. Blood tests and tests that measure how the nerves work are done. An MRI helps to rule out other conditions that cause similar symptoms. At first, the diagnosis can be difficult to make; it becomes clearer over time.
Treatment and care
There is not yet a cure for ALS. Some medicines target the disease itself, and some target symptoms such as cramps and drooling. Physiotherapy, speech therapy, communication aids and nutritional support are important. Care is regularly followed by a team of different specialists. The doctor who follows the disease decides which treatment is suitable.
For the family: inheritance and genetic counselling
Most people with ALS have no other affected person in their family. About 1 in 10 people have a family history. If there is ALS in the family, genetic counselling helps to understand the inheritance and the testing options.