Amyotrophic Lateral Sclerosis (ALS) is an idiopathic neurodegenerative disease that may result in death within two to three years of onset. It is a motor neuron disease that rapidly attacks and deteriorates the somatic neurons. Since it is idiopathic, science and medicine do not know much about it and have only been able to speculate at any sort of cause. Presently, there is no cure for ALS, and treatment options are severely limited. Also, there is no test for ALS, and it is only diagnosed when all other diseases that behave similarly, have been ruled out. 90-95% of cases occur seemingly without a cause, even if there are no known risk factors beforehand, with 10% of patients with a familial form on specific genes (Huether & McCance, 2012).
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Limb-onset, sometimes referred to as outside-in progression, is when the affected person’s first sign is muscular weakness in one of their limbs (National Institute of Neurological Disorders and Stroke (NIH), 2015). In one case, the patient first began to experience what is called “foot drop” unilaterally, and began falling more frequently. The muscle weakness spread up her foot into her leg, and then into the other leg, before progressing into her fingers and arms. The other type of progression is bulbar-onset, or outside-in progression (NIH, 2015). The first sign a person experiences can be slurred speech or difficulty swallowing. In an example of this, the patient began to have slurred speech and was unable to talk at all within a year. This progressed and she lost her ability to swallow, followed shortly by her ability to breathe effectively on her own. Each of these progression types, eventually lead to the other. If it is limb-onset, the later stages will include the beginning signs of bulbar, and vice versa. In the first patient, she began to experience dysphagia three years after diagnosis. In the second, she was unable to walk within two years of diagnosis. According to the ALS Association, the first signs and symptoms of the disease typically occur around 40-70 years of age and is 20% more common in men than women, it equalizes as both genders get older (2015). In these cases, the patients show no risk factors for the first half of their lives. Subjective findings in early limb-onset can be muscle weakness, fatigue, and muscle cramps. Objective findings can include, muscle spasms and muscle atrophy. Early bulbar-onset subjective findings include difficulty swallowing, though this can be objective with proper testing, a rise in vocal pitch, and getting winded easily. Objective findings include dysphagia
Limb-onset, sometimes referred to as outside-in progression, is when the affected person’s first sign is muscular weakness in one of their limbs (National Institute of Neurological Disorders and Stroke (NIH), 2015). In one case, the patient first began to experience what is called “foot drop” unilaterally, and began falling more frequently. The muscle weakness spread up her foot into her leg, and then into the other leg, before progressing into her fingers and arms. The other type of progression is bulbar-onset, or outside-in progression (NIH, 2015). The first sign a person experiences can be slurred speech or difficulty swallowing. In an example of this, the patient began to have slurred speech and was unable to talk at all within a year. This progressed and she lost her ability to swallow, followed shortly by her ability to breathe effectively on her own. Each of these progression types, eventually lead to the other. If it is limb-onset, the later stages will include the beginning signs of bulbar, and vice versa. In the first patient, she began to experience dysphagia three years after diagnosis. In the second, she was unable to walk within two years of diagnosis. According to the ALS Association, the first signs and symptoms of the disease typically occur around 40-70 years of age and is 20% more common in men than women, it equalizes as both genders get older (2015). In these cases, the patients show no risk factors for the first half of their lives. Subjective findings in early limb-onset can be muscle weakness, fatigue, and muscle cramps. Objective findings can include, muscle spasms and muscle atrophy. Early bulbar-onset subjective findings include difficulty swallowing, though this can be objective with proper testing, a rise in vocal pitch, and getting winded easily. Objective findings include dysphagia