The Typical Course of Treatment for ALS
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disease characterized by muscle weakness and atrophy, which can affect breathing, swallowing, and talking. The most common cause of death among people with ALS is respiratory failure due to the muscles involved in breathing becoming weak. While there’s no cure for ALS and treatment options are limited, some therapies exist to mitigate the symptoms of ALS and increase life expectancy and quality of life in patients with the condition. Here’s an overview of what you can expect from the course of treatment for ALS.
While there is no cure for amyotrophic lateral sclerosis (ALS), treatments may help slow its progression. People with ALS usually are treated by a team that includes at least one neurologist, one physician who specializes in treating muscle-related disorders (neuromuscular medicine specialist), and one physical therapist. Other specialists involved in treatment include pulmonologists, gastroenterologists, ophthalmologists, otolaryngologists, and orthopedic surgeons. Supportive care also plays an important role in ALS treatment.
Examples of supportive care include:
Respiratory support . Some people with ALS need to use ventilators to breathe and/or supplemental oxygen. In some cases, individuals also receive noninvasive positive pressure ventilation through masks or mouthpieces or tracheostomy tubes that provide continuous breathing assistance.
Health care team . People with ALS may benefit from physical therapy, speech therapy, occupational therapy, and nutritional counseling. A dietitian can help create an individualized meal plan based on a person’s needs.
Medications . There are no medications currently available to treat ALS itself. However, medications are available to manage symptoms like spasticity, depression and other psychological issues, drooling and excessive saliva production (dysphagia), constipation and other bowel problems, difficulty swallowing (dysphagia), excessive urination (polyuria), difficulty speaking (dysarthria), dizziness, lack of coordination or tremors.
Other therapies. Treatments may include acupuncture and supportive equipment such as splints, braces, crutches, walkers or wheelchairs.
Rehabilitation . Physiatrists, also known as rehabilitation physicians, often are involved in providing physical and occupational therapy.
Occupational therapists work with people with ALS to maintain function, such as independent feeding and self-care skills.
Physical therapists may focus on strength training or on range-of-motion exercises that keep muscles flexible and decrease pain.
Studies have shown that some individuals can increase their daily walking ability by using continuous positive airway pressure (CPAP) devices. This treatment involves blowing pressurized air into a mask placed over an individual’s mouth and nose while he or she sleeps at night. The goal is to reduce respiratory disturbances during sleep that can worsen breathing problems throughout the day. If you need help getting around, an occupational therapist can recommend adaptive equipment such as wheelchairs, walkers, bathroom equipment and seating systems for wheelchairs and cars.
An exercise physiologist can design an aerobic workout program that may slow down muscle loss caused by ALS.
A speech pathologist can create exercises to slow language deterioration. And although there currently are no drugs available specifically to treat speech problems associated with ALS, several medications commonly used for other disorders—such as antidepressants, antipsychotics and anticonvulsants—may be helpful for treating symptoms related to motor neuron disease. This includes improvement in slurred speech and dysarthria (speech disorder).
The course of amyotrophic lateral sclerosis (ALS) depends on a number of factors, including which areas of your body are affected by muscle weakness.