World ALS Day | Correctly understand ALS and scientifically diagnose and treat ALS

The International Alliance has designated June 21st of each year as "World ALS Day" to raise the world's awareness of amyotrophic lateral sclerosis (ALS), a serious disease.

Have you heard of ALS? ALS is now known as the first of the world's five terminal illnesses. In life, ALS makes many people turn pale. Although the global incidence of ALS is about 4/100,000 to 6/100,000, which seems not high, due to the large population base in my country, there are currently more than 200,000 patients, and we must pay great attention to it. So, what kind of disease is it? What are the causes, symptoms and treatments of ALS? Can it be identified early? On the "World ALS Day", Director Wang Nan, an expert in the Department of Neuroelectrophysiology at Dandong Central Hospital, gave us a popular science on this health topic, one by one, to correctly understand ALS and scientifically diagnose and treat ALS.

What is ALS?

"Lou Gestational and Lateral Sclerosis" is also known as amyotrophic lateral sclerosis. It affects both upper motor neurons and lower motor neurons and the trunk, limbs, head and facial muscles they control. It is a chronic progressive degenerative disease. Clinically, it is often manifested as progressive muscle weakness, muscle atrophy, fasciculations, medullary paralysis and pyramidal tract signs caused by combined damage to upper and lower motor neurons; some "Lou Gestational and Lateral Sclerosis" patients may also have varying degrees of cognitive and (or) behavioral disorders and other manifestations of involvement.

The causes and characteristics of ALS

1. The cause of ALS is still unclear. Some believe it may be related to heredity and genes; others believe it may be related to environmental factors, such as heavy metal poisoning.

2. The survival period of ALS patients is 2-3 years after the onset of symptoms. Only 5% to 10% of people can survive for 10 years or longer, and they often die of respiratory failure in the end.

What are the symptoms of ALS?

Clinical symptoms of ALS: muscle weakness, muscle atrophy, and muscle fasciculations; the first symptom is clumsy and weak movement of fingers on one or both sides, followed by atrophy of small muscles in the hands, gradually extending to the forearms, upper arms, and shoulder girdle muscles. As the disease progresses, muscle weakness and atrophy extend to the trunk and neck, and finally to the facial and throat muscles. Eventually, speaking, swallowing, eating, walking, and breathing become impaired. Other symptoms: In addition to motor symptoms, about 60% of ALS patients experience cognitive and/or behavioral changes. Patients generally have no objective sensory impairment, but often have subjective sensory symptoms, such as numbness, and sphincter function often remains good throughout the course of the disease.

Misconceptions about ALS

Misconception 1: If there is flesh twitching, it must be ALS.

In medicine, "muscle twitching" refers to muscle fasciculations and tremors. There are many reasons for this, which can be pathological or physiological (such as anxiety, depression, insomnia, fatigue, excessive exercise, drinking coffee, etc.). Therefore, "muscle twitching" does not necessarily mean "amyotrophic lateral sclerosis."

Misconception 2: Muscle atrophy means ALS.

Muscular atrophy can be seen in many diseases, the most common of which are cervical spondylosis, lumbar spondylosis, peripheral neuropathy, certain genetic diseases, etc. Therefore, muscular atrophy is not only seen in "ALS", but also needs to be differentiated from other diseases.

Misconception 3: ALS can be inherited.

ALS is divided into two types: familial and sporadic. Familial ALS accounts for about 5-10% and is inherited as an autosomal dominant trait, while most cases are sporadic ALS, which is not hereditary.

What tests can be used to diagnose ALS?

1. The diagnosis of ALS needs to be confirmed through neuroelectrophysiological examination (electromyography, nerve conduction examination, motor evoked potential, repetitive frequency electrical stimulation).

2. ALS has no cure so far. Treatments such as strengthening nutrition, using vitamins, acupuncture and physiotherapy, Chinese and Western medicines, etc. can improve the patient's symptoms and improve the quality of life.

3. Early identification of ALS is very important. It is crucial for the development of the disease, differential diagnosis and treatment. Early detection, early diagnosis, early symptomatic intervention and early improvement of quality of life should be carried out.

The exploration of the treatment of ALS has never stopped. I believe that in the near future, with the development of medical technology, the world's difficult problem of ALS will be solved.