The Progression of ALS Disease

The Progression of ALS Disease
The Progression of ALS Disease (Image: Zela)

ALS, also known as Lou Gehrig's disease, is a degenerative neurological disease of rapid progression. Affecting and destroying the motor neurons, ALS impairs the brain's ability to control and initiate muscle function, eventually leading to paralysis and death. The ALS Association reports that about 5,600 new cases are diagnosed each year in the United States, with 60 percent of new patients being male. Because ALS has no cure, it is critical for diagnosed patients to begin immediate and aggressive treatment to slow the degenerative process, which is unique in rate and characteristic for each individual.

Early Signs

The early symptoms of amyotrophic lateral sclerosis, or ALS, are subtle enough to be overlooked. The most commonly reported complaint leading up to diagnosis is muscle weakness or difficulty controlling a single limb. Examples may include tripping, dropping objects and muscle fatigue after performing common tasks, such as shaving, brushing teeth or hair, and writing. Slurring of words and a hoarse tone of voice occur from laryngeal muscle weakness, which can also produce difficulty in swallowing liquids. Unusual muscle twitches, called fasciculation, cramps and spasms may be present and painful in the early stages. An unexplained weight loss can result from depletion of bulk muscle mass.


Presentation of symptoms is dependent upon the location of the affected neurons. Speech and swallowing impairments are indicative of brain stem neuron degeneration and are termed "bulbar." Excessive salivation and the inability to swallow result in drooling. Choking and frequent aspiration can lead to pneumonia. About 25 percent of ALS cases begin with bulbar signs, with 75 to 85 percent of all ALS patients eventually developing these symptoms.


Loss of mobility in the arms and legs, weakness of the respiratory muscles and generalized muscle fatigue are somatic symptoms that indicate the degeneration of spinal cord nerve cells. Atrophy of these neurons results in muscle paralysis, leaving a patient debilitated and unable to care for himself. Most ALS sufferers die of respiratory failure when the diaphragm and muscles of the chest wall fail.


From the time of ALS diagnosis, the average patient survives three to five years. A small percentage of patients, with a slow-progressing form of the disease, have lived 10 to 20 years. This rare variation showed a spontaneous halt of progression, similar to remission. Depression is common among patients because their minds and senses remain unaffected and alert.


There is no cure for ALS, only medications to treat the symptoms. If a patient develops early warning signs, it is crucial to seek an immediate evaluation from a qualified neurology specialist. The damage done by ALS is not reversible, but lithium treatment has shown the promise of slowing the disease's progression.

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