Amyotrophic Lateral Sclerosis (ALS) aka Lou Gehrig’s Disease

ALS, or Lou Gehrig's disease as it is commonly known, is a progressive neurodegenerative disease of the nerve cells in the brain and spinal cord that control voluntary muscle movement. Patients with ALS experience a degeneration of motor neurons, the nerve cells in the central nervous system that initiate and control this voluntary movement of muscles. This progressive degeneration of motor neurons eventually culminates in the death of these nerve cells. When this happens, the brain loses its ability to initiate and control muscle movement. With voluntary muscle movement  progressively affected as ALS progresses, patients in the later stages of the disease can often become totally paralyzed. "Bulbar" ALS, another form of ALS also called Progressive Bulbar Palsy, prominently affects the muscles involved in speech, swallowing, and tongue movements.

Diagnosing ALS

It can be difficult to diagnose amyotrophic lateral sclerosis or ALS in its early stages because the disease can commonly resemble several other neurological diseases. Since ALS is a rare disease, it is likely that your physician will refer you to a specialized center, like Emory, where neurologists experienced in the diagnosis and care of ALS patients can work with you to rule out other conditions, and provide you with specialized care. There are no specific diagnostic tests for ALS. Depending on your symptoms and signs, your neurologist may or may not order other tests.

ALS Treatments

Because there is no known cure for ALS or Lou Gherig's Disease, the course of amyotrophic lateral sclerosis cannot be reversed. ALS treatments mainly involve efforts to slow the progression of ALS symptoms and provide patients with more comfort and independence.

ALS Medications
Riluzole (Rilutek) is the first and only medication approved by the Food and Drug Administration for slowing the degeneration caused by ALS. Riluzole appears to slow the ALS's progression in some people, perhaps by reducing levels of glutamate - a chemical messenger in the brain.

To help ease the symptoms of ALS, doctors at the ALS Center may also prescribe medications to provide relief from:

  • Muscle cramps
  • Constipation
  • Fatigue
  • Excessive salivation
  • Excessive phlegm
  • Pain
  • Depression

ALS Therapy
A variety of medical professionals may be involved in the diagnosis and treatment of ALS. Medical staff that may be included in an ALS patient's treatment team include:

  • A neurologist- the main physician responsible for and with expertise in the diagnosis, evaluation and management of the condition of ALS patients. He or she will prescribe or oversee the use of ALS diagnostic technology described above. 
  • Physical therapists- he or she can recommend low-impact exercises to maintain your muscle strength and range of motion as long as possible, helping you preserve a sense of independence.
  • An occupational therapist- he or she may be provided to aid patients in getting familiar with devices that will aid mobility and physical function.
  • A speech therapist- he or she is involved with ALS patients who experience difficulty speaking as a result of the disease.
  • An ALS Nurse- in collaboration with the treating ALS neurologist, he or she specializes in managing the multidisciplinary efforts involved in the treatment of ALS.
  • A dietician- he or she often works with the ALS speech pathologist to coordinate optimal hydration and nutrition and educates patients on the changes in nutrition required or seen with ALS.
  • A respiratory therapist- he or she specializes in the respiratory effects of ALS and educating ALS patients and families on these changes. The respiratory therapist will evaluate breathing and measure respiratory muscle strength in the patient. Respiratory therapists also provide expertise in the necessary equipment required to alleviate symptoms from the decline in respiratory strength often seen from ALS.
  • A social worker- he or she may be included in an ALS treatment team to provide emotional support to ALS patient and families. Social workers will also put patients in contact with relevant community resources and will assist patients with Social Security Disability and Medicare benefit. A social worker provides emotional support to patients and families, seeks out and mobilizes community resources, and assists in the process of obtaining Social Security Disability/Medicare benefits.
  • Other team members and services that may be included in an ALS patient treatment team include hospice services, orthotists, and additional assistive technologies.

About the Emory ALS Center

The Emory ALS Center provides multidisciplinary care for patients and families with amyotrophic lateral sclerosis (ALS) and related disorders. Our team of professionals attempt to anticipate needs before they become problems. Our combined expertise and experience allows us to approach and solve problems safely and efficiently. We maintain close collaborative relationships with the Muscular Dystrophy Association and the ALS Association of Georgia, allowing us to greatly extend our ability to care for people and families with ALS. The ALS Center combines state of the art clinical care with cutting edge clinical and basic research. The Emory ALS Clinic provides multidisciplinary care to ALS patients and their families, focusing on independence and quality of life through state of the art intervention. Our research focuses on basic mechanisms of motor neuron degeneration, genetics of ALS, and new experimental treatments.

Patients and families should call 404-778-3754 for information and appointments.

ALS Research
The Emory ALS Center adheres to the tripartite mission of Emory Healthcare, providing the best in patient care while training tomorrow's physicians and working to discover the causes and treatments for patients with ALS. The Emory ALS Center is a leader in ALS research through discovery in our laboratories and testing of new potential treatments. For an up to date listing of our research activities please visit www.neurology.emory.edu/ALS.

Conditions

Jeremy Williams

Emory ALS Patient, Jeremy Williams, stars in documentary about his struggle with ALS. Learn more.