ALS, or amyotrophic lateral sclerosis, is a degenerative neurological disease that can be difficult to diagnose. The reason ALS can be difficult to diagnose is that it can mimic other neurological diseases and that the symptoms are varied and manifest differently in individual patients. While one person might develop symptoms that would make it difficult to speak normally, another may only experience slight motor challenges when grasping small objects.
ALS – often called Lou Gehrig’s disease, because in 1939, the disease ended the career of this renowned and beloved major league baseball player – develops gradually and progresses differently in various people. Not all people experience the same set of symptoms or the same rate of progression and, as such, doctors and medical professionals have been searching for a reliable way to detect, treat, and diagnose ALS before it advances too far.
Diagnosing the Disease: Is There a Lab Test for ALS?
Currently, no single lab test will detect ALS. Instead, doctors and medical professionals must examine a patient on a clinical level to identify the symptoms that typically coincide with ALS. Diagnostic tests to rule out diseases that ALS mimics are also common. Some of the most common tests meant to diagnose ALS and rule out other conditions are as follows:
- Electromyography is one standard electrodiagnostic test typically used in the early phases of testing for ALS
- Blood tests and urine samples may be required, and doctors may examine blood and urine both for certain hormone levels and heavy metal concentration
- Spinal tap testing
- X-rays and MRIs
- Biopsies of the nerve and muscle
- Neurological examinations designed to assess the patient’s overall neurological health
It bears mentioning that, even after such testing, it often takes some time to diagnose a patient with ALS correctly.
Treatment for ALS
Once all of the relevant lab tests have been done, doctors will move into the treatment phase. Since the disease is so varied, however, no single treatment can diminish the damage ALS does to the body, or reverse its trajectory. Instead, doctors seek to use a combination of treatments to slow the progression of the illness and make patients more comfortable throughout.
Some of the most common treatments for ALS include the following:
Currently, there is only one drug approved by the FDA for the treatment of ALS. This medicine is called Rilutek and is designed to slow the progression of ALS in individual patients. The drug works by reducing enhanced levels of chemical messengers in the brain that exacerbate the symptoms of ALS.
In addition to Rilutek, doctors may prescribe medications used to treat the secondary symptoms of ALS, including spasticity, fatigue, pain, depression, and interrupted sleep.
In conjunction with medication, doctors may also prescribe a course of breathing support therapies to help counteract degrading respiratory muscles. A course of physical therapy or occupational therapy may also be helpful for people who have ALS, as remaining independent can become a challenge with time.
Speech therapy, nutritional support, and counseling are other complimentary treatments often meant for people who have ALS, since each of these helps people cope with the different mental, emotional, and social challenges the disease leverages.
The Prognosis for Patients with ALS
With ALS, it is the symptoms rather than the illness itself that kills people. The condition is invariably fatal, and people typically pass away as a result of respiratory failure within 3-5 years of the onset of the disease. While treatments like those mentioned above can extend the life of people living with ALS, there is no cure for the condition and the prognosis for people diagnosed is a life expectancy of between 3-10 years.
Living beyond five years, however, is uncommon, and only 10% of ALS patients meet or exceed the 10-year mark. That said, there are many things friends and family members can do to keep someone with ALS comfortable and ensure quality of life as the disease progresses, including hiring in-home care and making use of the treatments listed above.
Will There Ever be a Lab Test for ALS?
Doctors hope that one day, there will be a simple lab test to diagnose ALS. Currently, the National Institute of Neurological Disorders and Stroke is conducting research surrounding the disease, as is the National Institutes of Health. What’s more, the Centers for Disease Control and Prevention are working to locating risk factors in people with ALS and developing a sheet of potential causes for this troubling disease.
While it remains to be seen how the future of ALS and those diagnosed with it will pan out, doctors are working hard to streamline the diagnosing and treatment processes.