ALS (Lou Gehrig's Disease)
At Henry Ford’s Harry J. Hoenselaar ALS Clinic, our ALS patients have the advantage of expert diagnosis, early therapeutic intervention, the choice to participate in the newest clinical trials and ongoing care in a multidisciplinary team setting for the highest quality of daily life. Thousands of patients and their families have traveled to our clinic for diagnosis and care of this progressive disease, making us one of the busiest ALS clinics in Michigan.
What is ALS (or Lou Gehrig’s Disease)?
Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease, is a neuromuscular disease that gets worse over time. ALS involves a progressive degeneration of motor nerve cells (neurons) in the brain and spinal cord. When the motor neurons can no longer send impulses to the muscles, the muscles begin to waste away (atrophy), causing increased muscle weakness.
Signs and symptoms of ALS
Symptoms of this disease usually do not develop until after age 50, but they can start in younger people, too. People with ALS have a loss of muscle strength and coordination that eventually gets worse and worse, making it impossible to do routine tasks such as going up steps, getting out of a chair and even swallowing.
Symptoms of ALS include:
- Muscle weakness that slowly gets worse
- Difficulty breathing
- Difficulty swallowing—choking easily, drooling, gagging
- Head drop due to weakness of the neck muscles
- Muscle cramps
- Muscle contractions
- Speech problems, such as a slow or abnormal speech pattern (slurring of words)
- Voice changes, hoarseness
- Weight loss
Breathing or swallowing muscles may be the first muscles affected, but as the disease gets worse, more muscle groups develop problems. Muscle weakness commonly involves one part of the body first, such as the arm or hand, and eventually leads to difficulty lifting, climbing stairs and walking.
ALS does not affect the senses (sight, smell, taste, hearing, touch). It only rarely affects bladder or bowel function, eye movement or a person's ability to think or reason.
What causes ALS?
ALS affects approximately 5 out of every 100,000 people worldwide. 1 out of 10 cases of ALS are due to a genetic defect. For other cases, the cause is still unknown.
There are no known risk factors, except for having a family member who has a hereditary form of the disease.
Expert diagnosis of ALS at Henry Ford
ALS is not easily diagnosed. Neurologists at Henry Ford are experts at achieving an accurate and thorough diagnosis, using a range of advanced test to do so, including:
- Physical exam to review your medical history
- Blood tests to rule out other conditions
- Breathing tests to see if lung muscles are affected
- Electromyography (EMG) to see which nerves or muscles are not working properly. An EMG uses tiny electrodes to read the electric activity in your muscles. Our EMG laboratory is equipped with the most advanced instrumentation available and provides expertise in single-fiber EMG.
- Cervical spine CT or MRI to be sure there is no disease or injury to the neck, which can mimic ALS
- Head CT or MRI to rule out other conditions
- Genetic testing (if there is a family history of ALS)
- Swallowing studies
- Spinal tap (a lumbar puncture to remove a sample of cerebrospinal fluid for testing)
Personalized treatment at Henry Ford’s ALS Clinic
At Henry Ford, improving and maintaining your daily quality of life is our primary focus. Your care plan will involve a team of experts from different medical specialties to help address all of your needs. Studies have proven that the highest quality of life for ALS patients is achieved through this kind of coordinated care.
While you are being treated at our clinic, you will have your own room. The specialists who treat you include a neurologist, clinical nurse coordinator, nutritionist, speech-language pathologist, occupational therapist, physical therapist, social worker and psychologist. We also provide pulmonary and gastroenterology services, if needed. This unique approach emphasizes your comfort and eliminates the inconvenience of appointments spread across multiple locations.
While there is no cure for ALS, we may prescribe the following medicines to help manage your symptoms:
- Riluzole helps slow down the symptoms of ALS
- Baclofen or diazepam to treat (spasticity) muscle tightness that interferes with daily activities
- Trihexyphenidyl or amitriptyline for people with problems swallowing their own saliva
Clinical research trials are vital to finding new medications to help patients with ALS. At Henry Ford, our patients have the opportunity to participate in our ongoing clinical trials.
Other treatment approaches and therapies we offer for ALS include:
- Physical therapy
- Use of braces or a wheelchair
- Stomach tube for feeding (gastronomy)
- Breathing devices
Our program also provides support and resources for caregivers and family members.