Can early-stage ALS be cured?

Written by Shi De Quan
Neurology
Updated on September 19, 2024
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Amyotrophic lateral sclerosis, also known as motor neuron disease, is a condition that exclusively affects motor neurons without involving sensory neurons. Even if identified early, there are currently no specific medications to cure this disease; treatment can only be symptomatic and rehabilitative. Such approaches can alleviate symptoms. When symptoms are initially mild, medication can only slow down its progression but cannot cure it. The condition inevitably worsens gradually. Rehabilitative treatment can help reduce symptoms or delay the progression of the disease.

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Written by Li Qiang
Intensive Care Unit
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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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Written by Liu Hong Mei
Neurology
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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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Written by Liu Hong Mei
Neurology
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How to exercise for swallowing difficulties in people with amyotrophic lateral sclerosis

Swallowing difficulties in amyotrophic lateral sclerosis primarily involve exercises for oral muscles. Improvement in the movement of oral muscles can alleviate symptoms of swallowing difficulties. Rehabilitation training for oral muscle disorders mainly includes enhancing the movements of the lips, tongue, and lower jaw. Individuals with amyotrophic lateral sclerosis who have brainstem damage and medullary damage may experience swallowing difficulties, water drinking issues, and cough choking, primarily due to sensory disturbances in the throat. By utilizing temperature and sensory stimulation, the sensation in the patient's throat can be restored, allowing them to perceive the temperature and taste of food, thus reducing aspiration. After brainstem damage, the cricopharyngeal muscle does not open, which can be improved through balloon dilation and medication to enhance swallowing function.

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Written by Liu Hong Mei
Neurology
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How do people with ALS eat if they can't swallow?

Patients with amyotrophic lateral sclerosis (ALS) who no longer have swallowing function can be given nasogastric feeding and intravenous hyperalimentation to maintain nutrition and electrolyte balance. For patients with respiratory difficulties or respiratory failure, oxygen supplementation can be administered. This can be combined with treatments such as acupuncture, physical therapy, massage, and heat application. It is important to prevent complications such as pulmonary infections, aspiration pneumonia, hypostatic pneumonia, lower extremity venous thrombosis, acute gastritis, gastric mucosal erosion, and gastrointestinal bleeding, which are common in later stages of ALS. With the loss of swallowing function and decreased immunity, these complications can occur more frequently and require proactive treatment to improve nutritional status.

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Written by Zhang Hui
Neurology
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Does amyotrophic lateral sclerosis cause numbness in the hands?

Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease. Patients with this disease generally do not experience numbness in the hands, mainly because it primarily affects the motor system and does not impact the sensory system. Thus, the vast majority of patients will not have sensory disturbances or experience clinical manifestations of numbness in the hands. The specific causes and mechanisms of this disease are still not very clear, but they may be related to genetic factors, the toxic effects of excitatory amino acids, oxidative stress, and mitochondrial dysfunction. Symptoms in patients gradually worsen, and respiratory function impairment may also occur. However, so far, there is no effective cure.