Early symptoms of amyotrophic lateral sclerosis

Written by Zhang Hui
Neurology
Updated on September 29, 2024
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Amyotrophic lateral sclerosis (ALS) refers to motor neuron disease, with patients initially showing mainly reduced hand strength and clumsy fine motor activities, such as difficulty and lack of agility when using a screwdriver. There may also be atrophy of small muscles, such as the interosseous muscles of the hand and the hypothenar muscles, which are commonly seen in clinical settings. Some patients may initially exhibit symptoms like unclear speech, articulation disorders, and coughing or choking while drinking, which are important to recognize. As the disease progresses, the patient's generalized weakness becomes more apparent, with noticeable fasciculations and significant muscle atrophy developing clinically.

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Do people with ALS experience frequent muscle twitching?

Muscle twitching in people with ALS (Amyotrophic Lateral Sclerosis) can be very frequent. When muscles in ALS patients experience spasms, irritation, weakness, or fatigue, twitching is likely to occur. Muscle twitching in ALS patients is generally very frequent and is related to the disease. ALS, often referred to as motor neuron disease, is caused by degenerative changes in the central nervous system, such as the spinal cord and brain, leading to damage in the neuromuscular system, resulting in muscle atrophy, twitching, and tremors. It is advisable to seek medical evaluation and, once diagnosed, pursue active treatment which may include nutritional support, massage acupuncture, and functional exercise.

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Does amyotrophic lateral sclerosis skip generations in inheritance?

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, may possibly be inherited through generations. The exact cause of ALS is still not very clear, but there is a certain genetic predisposition. Patients with ALS gradually experience symptoms such as limb weakness and muscle atrophy. As the disease progresses, it will eventually lead to difficulties in speech, swallowing disorders, and breathing difficulties, resulting in the patient losing the ability to take care of themselves independently and requiring full-time care from others. Currently, ALS is an incurable disease. The treatment available to patients includes medications to nourish the nerves and systematic rehabilitation training. However, this treatment can only improve the symptoms to a certain extent and enhance the quality of life but cannot stop the progression of the disease. Eventually, the patient will be confined to bed.

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What should people with ALS do if they cannot eat?

People with amyotrophic lateral sclerosis who are unable to eat may try liquid and semi-liquid diets, using warm liquids, eating little by little. If they cannot consume a liquid diet, they may need to resort to nasogastric feeding. A gastric tube is used for feeding, through which high-nutrition, high-protein, and high-calorie diets can be provided to sustain and extend the life of those with the condition. Avoid overeating and engage in appropriate exercise, paying attention to the functions of the respiratory and digestive systems. If there is excessive saliva, a small amount of antihistamine medication can be administered. If there is an excess of phlegm, nebulized inhalation and expectorant medications might be provided. If feeding through a gastric tube is also limited, intravenous nutritional support can be given.

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Is it necessary to perform a tracheotomy in the late stages of ALS?

Patients in the late stages of amyotrophic lateral sclerosis (ALS) must undergo a tracheotomy because, by this stage, they have completely lost their motor abilities, including the muscle strength needed for breathing. Consequently, they lack the strength to breathe on their own, leaving them unable to survive without a ventilator. They must rely continuously on a ventilator to breathe as they cannot do it themselves. Therefore, if a ventilator is needed over the long term, a tracheotomy is necessary. This is because other methods, such as inserting tubes through the mouth or nose into the trachea to connect to the ventilator, are quite uncomfortable. Comparatively, tracheotomy offers a bit more comfort, making it a necessary procedure for connecting to a ventilator for long-term use and achieving greater comfort.

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Do people with ALS feel soreness and pain in their legs when lying down?

People with ALS often experience soreness and pain in their legs when lying down. In patients with ALS, certain neurons in the brain and spinal cord gradually degenerate and die, leading to muscle atrophy, nerve damage, muscle weakness, and stiffness, as if they are frozen. This muscle damage can lead to symptoms such as sore legs, general weakness, and fatigue. Over time, it may also cause difficulties in walking, speaking, eating, choking while drinking water, swallowing, and breathing. This can lead to systemic damage, complications like breathing difficulties, respiratory failure, and ultimately threaten life. The symptoms of leg pain and soreness in people with ALS, when lying down, can be alleviated through acupuncture, physical therapy, massage, and heat application.