Amyotrophic Lateral Sclerosis (ALS) Quiz

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Weak

Muscle spasm

Difficulty swallowing

Difficulty finding words when speaking

Muscle cramps

Weight loss

Choking on food

Muscle weakness

Slurred speech

Difficulty standing up from sitting position

Difficulty speaking

Muscle twitching at rest

Not seeing your symptoms? No worries!

What is Amyotrophic Lateral Sclerosis (ALS)?

Also known as ALS, Lou Gehrig's disease, or motor neuron disease, this progressive, degenerative condition affects the nerve cells in the brain and spinal cord. It results in loss of muscle control, eventually leading to difficulty eating, breathing, and speaking. The exact cause remains unknown and may be due to genetic, environmental, and lifestyle factors.

Typical Symptoms of Amyotrophic Lateral Sclerosis (ALS)

Diagnostic Questions for Amyotrophic Lateral Sclerosis (ALS)

Your doctor may ask these questions to check for this disease:

  • Do you have difficulty pronouncing words clearly?
  • Have you been experiencing difficulties with writing?
  • Have you been tripping or falling more often?
  • Is it hard for you to get up from a chair by yourself?
  • Do you have difficulty swallowing?

Treatment of Amyotrophic Lateral Sclerosis (ALS)

There is no cure for ALS. Medications can reduce symptom severity and slow progression. Physical, occupational, and speech therapy can help improve quality of life.

Reviewed By:

Benjamin Kummer, MD

Benjamin Kummer, MD (Neurology)

Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.

Shohei Harase, MD

Shohei Harase, MD (Neurology)

Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.

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Content updated on Dec 6, 2024

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  • History - considers past illnesses, surgeries, family history, and lifestyle choices.

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Symptoms Related to Amyotrophic Lateral Sclerosis (ALS)

Diseases Related to Amyotrophic Lateral Sclerosis (ALS)

FAQs

Q.

Is it ALS? Why These Symptoms Are Misunderstood & Your Medical Next Steps

A.

There are several factors to consider when you are worried about ALS symptoms: ALS is uncommon and many early signs like twitching are usually from benign or treatable causes, but progressive focal weakness that spreads, persistent twitching with weakness, speech or swallowing changes, or breathing problems are red flags that need prompt medical care. Below you will find the fuller picture on what ALS typically does and does not cause, common look alikes, how doctors evaluate it, and clear next steps such as tracking progression, seeing your primary care clinician, asking for a neurology referral, using a structured symptom checker to prepare, and seeking urgent care for severe symptoms.

References:

* Turner MR, Kiernan MC. Diagnostic challenges and pitfalls in amyotrophic lateral sclerosis. J Neurol. 2020 Jul;267(7):1857-1865. doi: 10.1007/s00415-020-09852-z. Epub 2020 Apr 29. PMID: 32347318; PMCID: PMC7301099.

* Benatar M, Wuu J. Clinical features and diagnostic approach to amyotrophic lateral sclerosis. J Neurol. 2022 Sep;269(9):4667-4680. doi: 10.1007/s00415-022-11109-7. Epub 2022 May 25. PMID: 35614275; PMCID: PMC9422839.

* Shefner JM, Al-Chalabi A. Diagnostic criteria for amyotrophic lateral sclerosis: What has changed in the last 25 years? J Neurol Sci. 2017 Oct 15;381:221-224. doi: 10.1016/j.jns.2017.07.026. Epub 2017 Jul 21. PMID: 28992917.

* Kiernan MC, Vucic S, Talbot K, et al. Practical approach to diagnosis and management of amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry. 2018 May;89(5):446-453. doi: 10.1136/jnnp-2017-317181. Epub 2018 Feb 21. PMID: 29467262.

* Masrori P, Van Damme P. Diseases that mimic amyotrophic lateral sclerosis: what every neurologist should know. J Neurol. 2021 Nov;268(11):4436-4447. doi: 10.1007/s00415-021-10705-z. Epub 2021 Jul 27. PMID: 34312891; PMCID: PMC8538741.

See more on Doctor's Note

Q.

What Is ALS? Why Your Muscles Fail and Medically Approved Next Steps

A.

ALS is a progressive neurodegenerative disease where motor neurons die, so the brain can no longer signal muscles, leading to weakness, atrophy, and eventual failure of movement, speech, swallowing, and breathing. There is no cure, but FDA approved therapies and early, multidisciplinary care can slow decline, so seek prompt medical evaluation, request neurologist testing like EMG, consider genetic counseling if relevant, and treat breathing or swallowing issues as urgent; there are several factors to consider, and key details that can change your next steps are outlined below.

References:

* Brown RH, Al-Chalabi A. Amyotrophic Lateral Sclerosis. N Engl J Med. 2017 Aug 10;377(12):162-172. doi: 10.1056/NEJMra1603471. PMID: 28792874.

* Hardiman O, Al-Chalabi A, Chio A, Diekstra F, Eisen A, et al. Amyotrophic Lateral Sclerosis: An Update on Etiology, Pathogenesis, Diagnosis, and Treatment. J Neurol. 2018 Jan;265(1):1-14. doi: 10.1007/s00415-017-8547-0. Epub 2017 Jun 24. PMID: 28647895.

* Mehta P, Kaye W, Bryan L, Solem M, Fagan L, Chiò A, Rowland LP, Sufit RL, Salameh JS, Bedlack RS, Rosenfeld J, Glass JD. Amyotrophic Lateral Sclerosis: A Review of Current and Future Therapies. JAMA Neurol. 2021 May 1;78(5):618-629. doi: 10.1001/jamaneurol.2021.0097. PMID: 33755030.

* Gagliardi D, Zoccolella S, Maimone S. Drug Development for Amyotrophic Lateral Sclerosis: A Critical Review. J Pers Med. 2022 Mar 22;12(3):511. doi: 10.3390/jpm12030511. PMID: 35339247; PMCID: PMC8954756.

* Tintignac C, Lagarrigue S. Molecular mechanisms underlying muscle atrophy in amyotrophic lateral sclerosis. Front Mol Neurosci. 2023 Jul 19;16:1193301. doi: 10.3389/fnmol.2023.1193301. PMID: 37537989; PMCID: PMC10395726.

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Q.

Is it ALS? Why Your Muscles are Twitching and Medically Approved Next Steps

A.

There are several factors to consider. Muscle twitching is common and, without progressive loss of strength, muscle wasting, or speech, swallowing, or breathing changes, it is rarely ALS. Medically approved next steps include cutting common triggers for 2 to 4 weeks, staying hydrated and rested, tracking symptoms without obsessing, using a reputable ALS symptom check, and seeing a doctor promptly if weakness or progression appears, with evaluation often involving a neurological exam and EMG; see complete details below.

References:

* Hobson, E. V., & McDermott, C. J. (2021). Do fasciculations predict ALS? *Journal of Neurology, Neurosurgery, and Psychiatry*, *92*(10), 1121-1126.

* Peters, T. L., Goutman, S. A., & Newman, E. A. (2023). Early diagnosis and management of amyotrophic lateral sclerosis. *Practical Neurology*, *23*(3), 209-216.

* Pellecchia, M. T., Vitale, C., Amboni, M., & Longo, K. (2021). Benign fasciculation syndrome: a systematic review of the literature. *Neurological Sciences*, *42*(7), 2665-2670.

* Burns, T. M., & Hobson, E. V. (2018). Evaluation of muscle twitching. *Primary Care*, *45*(4), 793-802.

* Shefner, J. M. (2023). The enigma of early diagnosis in amyotrophic lateral sclerosis: challenges and opportunities. *Current Opinion in Neurology*, *36*(5), 452-456.

See more on Doctor's Note

Q.

Is Your Body Short-Circuiting? The Reality of ALS and Medically-Approved Next Steps

A.

ALS is a rare but serious disease that damages motor neurons, causing progressively worsening muscle weakness that can affect walking, speech, swallowing, and breathing, yet most muscle symptoms have more common, treatable causes. Medically approved next steps are to seek prompt medical evaluation for persistent or progressive symptoms, especially urgent care for breathing or severe swallowing problems, since diagnosis relies on a neurological exam and EMG to rule out mimics, and treatments like riluzole, edaravone, and multidisciplinary care can slow progression and support quality of life. There are several factors to consider; important details that could guide your next move are explained below.

References:

* Goutman SA, Hardiman O, Al-Chalabi A, et al. Amyotrophic lateral sclerosis. Nat Rev Dis Primers. 2022 Mar 3;8(1):15. doi: 10.1038/s41572-022-00344-2. PMID: 35241624.

* Mehta P, Goutman SA, Malik A, et al. Current Treatment Options in Amyotrophic Lateral Sclerosis: A Review. JAMA Neurol. 2023 Feb 1;80(2):189-198. doi: 10.1001/jamaneurol.2022.4496. PMID: 36502391.

* Van Damme P, Robberecht W. The challenges of diagnosing and managing amyotrophic lateral sclerosis. Nat Rev Neurol. 2021 Mar;17(3):188-200. doi: 10.1038/s41582-020-00441-2. PMID: 33495632.

* Rothstein JD. Emerging therapies for amyotrophic lateral sclerosis. Nat Rev Drug Discov. 2023 Apr;22(4):259-278. doi: 10.1038/s41573-023-00669-7. PMID: 36922754.

* Visser-Meily A, van den Berg LH, Veldink JH, et al. Multidisciplinary management of amyotrophic lateral sclerosis. Curr Opin Neurol. 2021 Oct 1;34(5):713-720. doi: 10.1097/WCO.0000000000000969. PMID: 34470914.

See more on Doctor's Note

Q.

ALS Symptoms in Women 30-45: Early Signs & Your Next Steps

A.

Early ALS signs in women 30 to 45 include progressive muscle weakness that worsens over weeks to months, muscle twitching with weakness, cramps or stiffness, and sometimes changes in speech or swallowing, while numbness or tingling is not typical and twitching alone is rarely ALS. There are several factors to consider, including more common conditions that mimic ALS and when to seek urgent care, plus practical next steps like tracking symptoms and scheduling a medical evaluation with your doctor or a neurologist; see below for complete details that can guide your healthcare decisions.

References:

* Riancho J, de la Torre A, Matías-Guiu J. Sex Differences in Amyotrophic Lateral Sclerosis: A Systematic Review. Front Neurol. 2021 Apr 19;12:656461. doi: 10.3389/fneur.2021.656461. PMID: 33943360; PMCID: PMC8101456.

* Goutman SA, Hobson DE, Feldman EL. Amyotrophic lateral sclerosis: clinical features, diagnosis, and management. Lancet. 2021 Jul 17;398(10294):137-150. doi: 10.1016/S0140-6736(21)00725-7. PMID: 34267440.

* Yang X, Yang Q, Song C, Cui L, Liu M. Sex Differences in Risk Factors for Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis. Front Aging Neurosci. 2022 Oct 28;14:1044733. doi: 10.3389/fnagi.2022.1044733. PMID: 36382103; PMCID: PMC9650044.

* Chio A, Calvo A, Moglia C, Mazzini L, Verriello L, Bottacchi E, Caponnetto C, Conti R, D'Alfonso S, Salvi F, Trojsi F, Vasta R, Volanti P, Mora G, De Marco R, Filippi M, Sessa E, Santalucia P, SScLA. Delay in diagnosis of amyotrophic lateral sclerosis: clinical and prognostic implications. J Neurol Neurosurg Psychiatry. 2015 Oct;86(10):1136-41. doi: 10.1136/jnnp-2014-309623. Epub 2015 Jan 5. PMID: 25565545.

* Xu L, Li C, Zhang Q, Zhao M, Shi Z. Incidence and prevalence of amyotrophic lateral sclerosis: A systematic review and meta-analysis. J Clin Neurosci. 2017 Jan;35:109-113. doi: 10.1016/j.jocn.2016.09.006. Epub 2016 Oct 26. PMID: 27814831.

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Signify Health

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Benjamin Kummer, MD

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References