Amyotrophic Lateral Sclerosis (ALS) Flashcards
What is ALS
and
What causes ALS
Chronic degenerative disease that produces (BOTH) upper and lower motor neuron impairments
Significant loss of:
- anterior horn cells in the spinal cord
and
- motor cranial nuclei in lower brainstem produces:
- Weakness*
- Muscle Atrophy*
What attributes to UMN signs and what can this cause?
Demyelination of corticospinal and corticobulbar tracts.
Causes:
- denervation of muscles fibers
- muscle atrophy and weakness
Etiology
-UNKOWN-
Theories:
- Genetic Inheritance (autosomal dominant trait)
- Slow acting virus
- Metabolic Disturbances
- toxicity of lead and aluminium
Who has a higher incidence rate men or women?
- Higher incidence in men
Typical Age of Onset?
- disease typically begins between 40-70 y/o
Unlike MS this is for old bitches; MS 20-35(40)
Signs and Symptoms (LMN)
LMN Signs:
- asymmetrical muscle weakness
- fasciculations
- cramping
- atrophy in hands
Signs and Symptoms (UMN)
UMN Signs:
- incoordination of movement (cerebellum)
- spasticity
- clonus
- (+) Babinski Reflex
Signs and Symptoms (Other)
- Fatigue
- Oral Motor Impairments; bulbar symptoms
- Motor Paralysis with eventual Respiratory Paralysis
Treatment Options
- Supportive Care
- Symptom Management
All branches of rehab are involved in focusing on increase QOL.
What is bulbar involvement characterized by?
- Dysarthria
- Dysphagia
What laboratory or imaging studies would confirm diagnosis?
Electromyography: assesses fibrillation and muscle fasciculations.
Muscle Biopsy: to verify lower motor neuron involvement
Spinal Tap: May reveal higher protein content
What is a primary indicator of ALS?
A patient that presents with motor impairment (without) sensory impairment is a primary indicator of ALS.
What remains preserved throughout the course of ALS?
- Sensation
- Eye Movement
- Bowel and Bladder Function
Physical therapy and ALS; guidelines for an HEP?
- Low-Level Exercise
- Energy conservation techniques
HEP may be indicated; however patients SHOULD NOT exercise to fatigue; promoting further weakness
What is the average course of the disease?
Two to Five Years
(25% of patients surviving longer than 5 years)