Oct. 8, 2012 | Did you know that Lou Gehrig was the first baseball player ever to have his uniform number retired? Baseball’s “Iron Horse” played for the New York Yankees for 17 seasons, setting an American League mark with 184 RBIs in 1931 and hitting a record 23 grand slams. Gehrig’s consecutive games-played streak ended at 2,130 when he was felled by an illness that later carried his name. The disease that claimed Gehrig’s life in 1941, amyotrophic lateral sclerosis, is a rapidly progressive, invariably fatal neurological disorder that attacks the nerve cells responsible for controlling the body’s voluntary muscles. Based on U.S. population studies, a little over 5,600 people in the U.S. are diagnosed with ALS each year. Worldwide, ALS occurs in 1 to 3 people per 100,000. ALS often begins with muscle twitching and weakness in an arm or leg, or with slurring of speech, eventually affecting the patient’s ability to control the muscles needed to move, speak, eat and breathe.

Oct. 8, 2012 | The symptoms of amyotrophic lateral sclerosis or ALS are often so subtle or slight that they may go overlooked. The early signs vary with each individual, but usually include weakness in an arm, causing trouble opening jars or lifting a hand above the head, weakness in a leg causing the patient to trip or have trouble with stairs, or changes in their voice, trouble swallowing, or shortness of breath. In association with this, they may have cramps or muscle twitches. The hands and feet may be affected first, causing difficulty in lifting, walking or using the hands for the activities of daily living such as dressing, washing and buttoning clothes. As the weakening and paralysis continue to spread to the muscles of the trunk of the body the disease, eventually affects speech, swallowing, chewing and breathing. As breathing muscles become affected, patients may use non-invasive ventilation, similar to the machines used for sleep apnea, to help with their breathing.

Oct. 8, 2012 | We know that pro football is a hard-hitting game but a recent report found more evidence that a career in the sport may be linked to degenerative brain disease. As part of a study published last month in the medical journal Neurology, a team from the National Institute of Occupational Safety and Health gathered data from more than 3,400 former NFL players with at least five seasons on the field. 334 of the players had passed away, allowing researchers to look at their cause of death. When compared to the general American population, the data showed pro football players were three times more likely to die from neurodegenerative causes. However, they were four times more likely to die from Alzheimer’s disease and amyotrophic lateral sclerosis. The position the player held also appears to factor in. So called “speed” positions, where high-speed collisions are more prevalent, such as quarterbacks and running backs, were at higher risk than linemen.

Oct. 8, 2012 | Amyotrophic lateral sclerosis is difficult to diagnose early because its symptoms may appear similar to those of other neurological diseases. Most people who develop ALS are between the ages of 40 and 70, with an average age of 55 at the time of diagnosis. A diagnosis is based on a careful medical history, a physical exam of the nervous system, and tests that evaluate nerve and muscle function. If a physician suspects ALS, the patient should be referred to a neurologist for diagnosis and treatment. A medical history and detailed physical exam of the nervous system can usually help the neurologist diagnose the patient’s condition. The tests needed to confirm the diagnosis include an electromyogram or EMG and nerve conduction studies. Depending on the neurologist’s findings, other tests may be needed, including a spinal tap, also known as a lumbar puncture, which is used to collect and analyze the fluid surrounding the brain and spinal cord.

Oct. 8, 2012 | Because there’s no way to reverse the course of amyotrophic lateral sclerosis, treatments mainly involve efforts to slow the progression of symptoms and make the patient more comfortable and independent. The drug riluzole (PRONOUNCED rill-you-zole) is the first and only medication approved by the Food and Drug Administration for slowing ALS. The drug appears to slow the disease’s progression in some people, perhaps by reducing levels of glutamate, a chemical messenger in the brain that’s often present in higher levels in people with ALS. Certain drugs may be prescribed to help individuals with spasticity, pain, panic attacks, and depression. Physical therapy, occupational therapy, and rehabilitation may help to prevent joint immobility and slow muscle weakness and atrophy. Most people with ALS die from respiratory failure, usually within 3 to 5 years from the onset of symptoms. However, about 10 percent of those individuals with ALS survive for 10 or more years.