Amyotrophic Lateral Sclerosis, or ALS, is commonly called Lou Gehrig’s disease. Known more for the people who have it, than its clinical presentation. ALS is an incurable, progressive neurological disorder.
“What people end up with is a degeneration of the nerves that go through the skeletal muscles. As a result of that, there is atrophy of the muscles,” says Dr. Nima Mowzoon, neurologist on Lee Memorial Health System’s medical staff.
For reasons we don’t know, nerve cells of the brain and spinal cord that control muscle movement deteriorate, leading to paralysis and death. People generally start noticing symptoms in their 50s or 60s.
“It usually starts out as a painless weakness. That weakness is usually present for a period of time before patients come to the doctors,” says Dr. Mowzoon.
Early stage symptoms include: weakness in one limb, clumsiness of the hands, impaired speech and difficulty walking.
“A patient may have a foot drop or hand weakness. It starts in a limb and progresses to the contiguous limb. So it can go to the leg on the same side or it can go to the opposite arm for instance - that sort of thing,” says Dr. Mowzoon.
Getting a definitive diagnosis is made through a series of tests and evaluations, in part by ruling other things out. Part of the criteria includes monitoring the progression.
“Diagnosis is a combination of a clinical presentation and a use of EMG, electromyography, which is nerve and muscle testing. To diagnose somebody you would need to have three different segments involved,” says Dr. Mowzoon.
Without a cure, patients utilize therapy to compensate for their lost abilities. Fort Myers is home to one of a handful of ALS clinics in the state.
“The clinic brings together all the ancillary services that the patient needs. There’s physical therapy, occupation therapy, speech therapy, a dietician will get to see them. Bottom line is the clinic helps people live a good quality of life,” says Dr. Mowzoon.
And once again, the focus of ALS is on the people who have it.