Is amyotrophic lateral sclerosis (ALS) contagious?

Written by Liu Hong Mei
Neurology
Updated on September 01, 2024
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Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig's disease, is not contagious. It is a genetic disease associated with autosomal dominant inheritance and is not considered an infectious disease. The exact cause of ALS is still unclear. Commonly identified mechanisms include genetic factors, inflammatory agents, excitotoxic effects from amino acids, infections, autoimmune factors, exposure to toxins, and heavy metal poisoning from metals like lead, mercury, and aluminum. Other contributing factors may include a deficiency in nerve growth factors, mitochondrial dysfunction, and apoptosis. These factors may likely be involved in the development of ALS symptoms, but the disease is not communicable.

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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 Li Qiang
Intensive Care Unit
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What to do with respiratory failure in the late stage of amyotrophic lateral sclerosis?

Amyotrophic Lateral Sclerosis (ALS) is an irreversible disease, also known as motor neuron disease. Its motor function deteriorates progressively and irreversibly. Therefore, in the advanced stages, respiratory failure can only be managed with the help of a ventilator, which assists the patient's breathing mechanically. Consequently, patients typically require a tracheotomy in the late stages of the disease. Once connected to a ventilator via a tracheotomy, the ventilator becomes a permanent necessity. If at any point the ventilator is stopped, the patient would die due to lack of oxygen and the accumulation of carbon dioxide in the body. Therefore, they must wear the ventilator for life. Inevitably, this leads to respiratory-related complications, such as lung infections.

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Written by Zhang Hui
Neurology
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Can amyotrophic lateral sclerosis be relieved?

Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease, and generally speaking, there are no effective alleviation measures for this disease. Currently, the specific causes and pathogenesis of this disease are not very clear. Various factors lead to the simultaneous damage of both upper and lower motor neurons in patients. Clinical manifestations include muscle weakness, muscle atrophy, and fasciculations. Additionally, patients may experience difficulties with swallowing, choking while drinking water, and speech disorders. In its most severe form, it can affect breathing, leading to respiratory failure. This disease progressively worsens, and the prognosis is generally poor with no effective relief methods available.

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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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Is it normal for someone with ALS to have severe swelling in their feet?

ALS patients with severe foot swelling is not normal. If an ALS patient experiences severe swelling of the feet, it is important to be cautious of the formation of blood clots in the lower limb vessels. The formation of venous blood clots can lead to poor blood circulation, easily causing blood stasis and thrombotic obstruction, leading to severe swelling of the feet. It is necessary to conduct a Doppler ultrasound of the lower limb vessels to assess their condition. Treatments may include anti-platelet aggregation, anticoagulation, promoting blood circulation to remove blood stasis, and providing nutritional support to nerves. Heat application, keeping warm, promoting lower limb blood circulation, acupuncture, physical therapy, massage, and heat application can be used as symptomatic treatments. For ALS patients with severe foot swelling, it is advisable to elevate the lower limbs during sleep, perhaps covering them with a blanket or elevating them about 45 degrees.