Amyotrophic lateral sclerosis

Introduction:ALS, amyotrophic lateral sclerosis, is progressive neurodegenerative disease that mainly involve the nerve cells responsible for controlling voluntary muscles movement. There are two different types of ALS, sporadic and familial. ALS usually strikes people between the ages of 40 and 70. ALS often begins with muscle twitching and weakness in limb or slurred speech. There is no definite cure for ALS and eventually the disease is fatal.Case report:A 50 year old man was admitted with dysphagia and progressive weight loss from one year ago and muscle weakness in the neck.Systematic examination showed no evidence of fever, lymphadenopathy and organomegaly.During neurologic examination the positive points were reduction of gag reflex, reduction of SCM and Trapezius force, weakness of tongue and tongue atrophy and fasciculation. His mental state was normal.Motor examination revealed generalized wasting, neck and tongue muscles atrophy, fasciculation in lower limbs. Deep tendon reflexes were increased in lower limb but plantar reflex was normal. Lower and upper limbs force was 5/5. Pelvis and abdomen sonogeraphy and CT scan showed no abnormality but endoscopy showed gastritis.NCV was normal and EMG showed neurogenic changes. MRI was normal.Conclusion:The most important point is differential diagnosis. According to clinical criteria, EMG, NCV and our examination we ruled out cervical spondylosis and diagnosed ALS. Treatments can reverse the damage of ALS, but they can slow the progression of symptoms. Medications are currently approved by the FDA for the treatment of ALS: Rilozule and Edaravone.We also prescribed medications to provide relief from other symptoms like Muscle cramps and spasms, Spasticity, Constipation, Fatigue, Motor weakness, Depression and Sleep problems. We also suggested physical therapy for pain management.

کلیدواژه ها:

ALS ، motor neuron diseases ، weakness of muscle