ALS Symptoms: What to Expect and When to Seek Help - Neurology

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Symptoms of Amyotrophic Lateral Sclerosis (ALS)


Hello Doctor, I started feeling weakness in my right hand and right foot when I got up on February 21.
It feels unusual, but I can still exert strength if I try hard; otherwise, it feels soft as if I had engaged in intense exercise.
My right hand also feels less agile than usual.
I went to the hospital for an EEG and upper and lower limb evoked potentials, and I have an MRI scheduled for next month.
Does the doctor think that the reason for these tests is the possibility of amyotrophic lateral sclerosis (ALS)? Additionally, for the past two days, I've had a scratchy throat when swallowing saliva, which causes me to cough.
Could this be an indication that the throat muscles are beginning to degenerate due to ALS? I am really scared and anxious waiting until next month, so I hope the doctor can provide some preliminary answers to help me mentally prepare.
Thank you, Doctor!

Luo Tongxue, 20~29 year old female. Ask Date: 2022/02/28

Dr. Jiang Junyi reply Neurology


Hello, Student Luo:
You mentioned "EEG and upper and lower limb evoked potentials, and next month there will be an MRI." Essentially, EEG is not a diagnostic tool for motor neuron diseases.
Your concern about amyotrophic lateral sclerosis (ALS) primarily refers to issues with motor neurons, which control muscle movement.
Generally, the motor neurons in the brain are referred to as upper motor neurons, while those in the brainstem and spinal cord are called lower motor neurons.
When motor neurons become damaged, our muscles do not receive adequate nutrients and chemicals, which can lead to muscle death.
Clinically, diagnosis requires methods such as electromyography (EMG) and muscle biopsy.
For nerve repair, it is recommended to supplement with B vitamins.
I suggest discussing your tests and treatment options with your attending physician.
Thank you for your question, and feel free to discuss any related issues further! Wishing you good health, peace, and joy.
Dr.
Jiang Junyi, Taoyuan Medical Center, is concerned about you.

Reply Date: 2022/02/28

More Info


Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig's disease, is a progressive neurodegenerative disorder that affects motor neurons in the brain and spinal cord. This condition leads to muscle weakness, disability, and eventually death, typically within three to five years after diagnosis, although some patients may live longer. Understanding the symptoms, prognosis, and when to seek medical help is crucial for managing this condition.


Symptoms of ALS
The symptoms of ALS can vary significantly from person to person, but they generally include:
1. Muscle Weakness: This is often the first noticeable symptom. Patients may experience weakness in the hands, arms, legs, or feet. As you described, feeling weakness in your right hand and leg could be indicative of this symptom.

2. Muscle Cramps and Twitches: Involuntary muscle contractions (fasciculations) may occur, often in the arms and legs.

3. Difficulty with Coordination and Balance: Patients may find it challenging to perform tasks that require fine motor skills, such as buttoning a shirt or typing.

4. Speech and Swallowing Difficulties: As the disease progresses, it can affect the muscles involved in speaking and swallowing, leading to slurred speech and difficulty swallowing, which you mentioned experiencing as a "tickling" sensation in your throat.

5. Respiratory Issues: Weakness in the respiratory muscles can lead to breathing difficulties, especially during physical exertion.

6. Cognitive Changes: While ALS primarily affects motor function, some patients may experience changes in cognition or behavior, although this is less common.


Prognosis
The prognosis for ALS varies widely among individuals. While the average life expectancy after diagnosis is three to five years, some patients can live for a decade or longer. Factors influencing prognosis include the age of onset, the rate of progression, and the specific symptoms experienced. Early diagnosis and intervention can help manage symptoms and improve quality of life.


When to Seek Help
If you are experiencing symptoms such as muscle weakness, coordination issues, or swallowing difficulties, it is essential to seek medical attention. The tests you have undergone, including EEG and nerve conduction studies, are standard procedures to evaluate neurological function and rule out other conditions. An MRI can provide further insights into the structural aspects of the brain and spinal cord.


Managing Anxiety and Fear
It is entirely normal to feel anxious and fearful when experiencing concerning symptoms, especially when they may suggest a serious condition like ALS. Here are some strategies to manage these feelings:
1. Stay Informed: Understanding ALS and its symptoms can help demystify the condition and reduce fear. However, be cautious about excessive internet searching, which can lead to misinformation and increased anxiety.

2. Communicate with Your Healthcare Provider: Keep an open line of communication with your doctor. Discuss your symptoms, concerns, and the results of your tests. They can provide clarity and reassurance.

3. Seek Support: Consider joining a support group for individuals with ALS or those experiencing similar symptoms. Sharing experiences with others can provide comfort and understanding.

4. Mental Health Support: If anxiety becomes overwhelming, consider speaking with a mental health professional. They can provide coping strategies and support tailored to your situation.

5. Focus on What You Can Control: While waiting for test results, focus on maintaining a healthy lifestyle, including a balanced diet, regular exercise (as tolerated), and adequate rest.

In conclusion, while your symptoms are concerning, they do not definitively indicate ALS. The diagnostic process can be lengthy, but it is essential to remain proactive in seeking answers and managing your health. Remember, early intervention and support can significantly impact your quality of life.

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