What are the symptoms of ALS? What are the symptoms of ALS?

Typical symptoms: upper and lower motor nervous system involvement is the main manifestation. Common symptoms:

Muscle weakness, muscle atrophy, and fasciculations are manifestations of lower motor nervous system involvement; Hypertonia, hyperreflexia, and positive pathological signs are the main manifestations of upper motor nervous system involvement. Other symptoms: the presenting symptom can be a variety of manifestations depending on the patient.

Most patients have asymmetrical local limb weakness, such as stiff walking, procrastination, easy falling, and inflexible finger movement. Bulbar symptoms such as dysphagia and dysarthria. A small number of patients present with respiratory symptoms.

ALS, also known as motor neuron disease, is a chronic condition.

The clinical characteristics of this disease are: 1. Insidious onset and progressive aggravation, mainly manifested as distal limb muscle atrophy, weakness, hypertonia, fasciculation, difficulty in moving, bulbar paralysis, dysarthria, choking on eating, breathing and swallowing disorders, hyperreflexia and positive pathological features. There is usually no sensory impairment.

2. The disease is most affected by middle-aged people, mostly between 40-50 years old, but it can also occur in childhood and after the age of 70. There are 2-3 times more males than females, and some patients have a positive family history, usually inherited in an autosomal dominant manner.

The earliest symptoms of motor neuron disease are:

1. Asymmetrical weakness of the limbs, or arthria, the onset of the upper limbs mostly starts from the weakness of the shoulder, and sometimes the distal weakness is often more obvious after a slight local injury, which is manifested as the weakness of holding objects, approximately.

Thirty-five percent of patients begin in the upper extremities, and about 40 percent begin in the lumbar spinal cord, and these patients claudible due to unilateral foot drop or difficulty standing due to weakness.

2. Early muscle cramps are common, and they are mostly in the proximal and distal muscles of the lower limbs affected. Muscle beats can be a cause for concern, and sometimes muscles beat months before weakness and muscle atrophy.

3. With the development of the course of the disease, almost all patients with the onset of limbs will have bulbar symptoms, and the weakness will be further aggravated, and the muscle beating will become insignificant. Conversely, people who develop bulbar symptoms end up with extremity symptoms.

Clinical manifestations 1) According to the severity of the lesion, two types of symptoms can be seen: 1. The symptoms of upper neurons include: deterioration of fineness, muscle weakness, spasticity, pathological reflexes, curvature spasm and pseudobulbar signs.

2. Symptoms of lower neurons include: muscle weakness, muscle atrophy, decreased reflexes, muscle tremors, and cramps. At first, it may be just a general symptom such as peripheral limb weakness, muscle twitching, and easy fatigue, but gradually it will progress to muscle atrophy, difficulty swallowing, and finally respiratory failure.

2) According to the different symptoms at the beginning, it can be divided into two modes of disease development: 1. It starts with the invasion of the limbs: the muscles of the limbs begin to atrophy and weaken from a certain place, and then spread to other parts, and finally produce respiratory failure.

2. Start with bulbar muscle paralysis: when the limbs are still moving well, the symptoms of difficulty swallowing and speaking have appeared, and then soon progress to respiratory failure. Methods There is no effective way to succeed than the so-called "cocktail", i.e., a synthesis of multiple possible causes.

A variety of combinations targeting different aspects of ALS disease include: anti-glutamate drugs, neuroprotective agents, neurotrophic factors, symptomatic agents, and stem cell genes. The only drug approved for use in **ALS is riluzole (rilutek), which has been confirmed in clinical trials to prolong the life of patients with ALS for up to 3 to 6 months, and its role is mainly to delay the progression of the disease, rather than **ALS; In addition, some trials have shown that vitamin E can delay the progression of the disease, but it does not prolong the life of the patient.

Many other promising drugs, including epilepsy drugs, COX-2 selective inhibitory drugs and adjuvants, are in clinical trials. 1. Anti-glutamate drugs include 1) riluzole (rilutek, riluzole) 100mg daily, which is the only drug that has been proven to be effective, although the effect is limited, but after all, it is the beginning of the drug's effectiveness. 2）lamotrigine；3) Branched-chain amino acids, including L-leucine, L-isoleucine, and L-valine, mainly to enhance the oxidation of glutamic acid; 4）gabapentin；5) D-methoxymethylmorphine.

The latter four require more clinical trials to evaluate efficacy. 2. Neuroprotective agents include 1) vitamin E; （2）selegiline；(3) N-acetylcysteine; (4) DHA dehydroepiandrosterone. The neuroprotective effects of neuroprotective agents have not been proven.

3. Nerve growth and trophic factors: insulin-like growth factor-1. Symptomatic** include non-invasive biphasic positive pressure ventilation (BIPAP), percutaneous endoscopic gastroenterostomy (PEG), mucolytics, antidepressants**, sleeping pills, and daily care.

Amyotrophic lateral sclerosis is often referred to as ALS. It is a type of motor neuron disease that affects upper and lower motor neurons, resulting in weakness and atrophy of the muscles in the innervated area. ALS symptoms often begin with weakness and clumsiness of the fingers, and gradually appear atrophy of the hand muscles, which will extend to the muscles of the limbs and trunk as the disease progresses, and finally involve the respiratory muscles, causing dyspnea.

1. Asymmetrical local limb weakness, most patients will show some mild symptoms before suffering from ALS, and the most important symptoms are manifested in local limb weakness, such as weak legs, procrastinating when the patient walks normally, and is easy to fall. The muscles of the patient's body first atrophy from the small muscles of the hand, which is manifested as instability and inflexibility when the patient does some delicate work or small movements. For example, if the patient uses a key to open the door, it will not be inserted into the lock hole, and the things in the hand will fall off without knowing when.

Second, the condition of the respiratory system deteriorates, after the condition of ALS patients develops to a certain situation, a small number of patients will have symptoms such as poor breathing, obstruction, weak speech, gasping for breath when walking at close range, and being in a state of hypoxia. This is because the muscles that control breathing begin to atrophy and become unable to work, eventually leading to respiratory disorders such as difficulty breathing. Statistics show that most ALS patients eventually die from respiratory failure or other complications.

3. Large-scale atrophy of the muscles of the whole body, when the muscles of the whole body are atrophied in a large area, the performance in life is already very obvious. At this time, there will be a "flesh jumping" sensation, tremors of muscle groups, cramps, and unconsciously downward closing of the eyelids, which will expand to other muscles throughout the body, including the deep muscle groups. When ALS patients enter the later stage of the course of the disease, in addition to the free movement of the eyeball, all motor systems of the whole body will be affected, and eventually lead to inability to function and paralysis of the whole body.

The early symptoms of ALS are weakness and atrophy in one finger, and sometimes the finger muscles are throbbing.

ALS, also known as amyotrophic lateral sclerosis, is a motor neuron disease. **Unclear, 5 out of 10 patients are familial. The disease mostly appears in 35-45 years old.

The first symptom is inflexible finger movement, followed by atrophy of small muscles of the hand such as thenar and vermiform, and gradually develops of the forearm, upper arm and shoulder girdle muscles, and the atrophic muscles appear coarse fasciculations, extensor weakness and flexor weakness, decreased and absent tendon reflexes of the upper limbs, and muscle weakness and inability to walk in the lower limbs. A small number of cases start from the lower limbs and gradually involve the upper limbs, and some patients have symptoms of choking on drinking water, only the extraocular muscles are not affected, combined with limb sensation, numbness and pain. Late in the course of the disease, death due to ventilator paralysis.

If the disease can be detected in time, multidisciplinary integration is adopted as soon as possible**, and nutritional, respiratory and psychosocial support can be strengthened through medication**, exercise training, and nutritional, respiratory and psychosocial support, the quality of life can be improved to a certain extent and the survival period can be appropriately prolonged.

Typical symptoms.

1. Muscle weakness and muscle atrophy.

2. Obvious fasciculations.

3. Generally, there is no objective sensory disorder, and there are often subjective sensory symptoms, such as numbness.

4. The function of the sphincter is usually maintained well.

5. The patient's consciousness is always awake.

Accompanying symptoms. With bulbar palsy: generally occurs in the late stage of the disease, the tongue muscles are often affected first, manifested as tongue muscle atrophy, fasciculation, and tongue protrusion weakness, followed by palate, pharyngeal, laryngeal, and masticatory muscle atrophy and weakness, resulting in the patient's slurred arthria, dysphagia, and chewing weakness. The orbicularis oculi muscle is most commonly involved in the facial muscles, and the extraocular muscles are generally unaffected.

Amyotrophic lateral sclerosis (ALS) is also known as motor neuron disease (MND), the latter name is commonly used in the United Kingdom, Charcot disease in France, and Lou Gehrig disease in the United States.

In China, amyotrophic lateral sclerosis and motor neuron disease are commonly mixed. It is caused by damage to the upper and lower motor neurons, resulting in gradual weakness and atrophy of the muscles including the bulbar (the bulbar refers to the part of the muscles innervated by the medulla), limbs, trunk, chest and abdomen.

The condition of amyotrophic lateral sclerosis is still unknown. In 20% of cases, it may be related to heredity or genetic defects. In addition, some environmental factors, such as heavy metal poisoning, can cause motor neuron damage. The main theories of the causes of motor neuron damage are:

1.Neurotoxic substances accumulate and glutamate accumulates between nerve cells, causing damage to nerve cells over time.

2.Free radicals damage nerve cell membranes.

3.Nerve growth factor deficiency prevents nerve cells from growing and developing sustainably.

Clinical presentation. Early symptoms are mild and can be easily confused with other diseases. Patients may only feel some symptoms such as weakness, flesh jumping, and fatigue easily, and gradually progress to generalized muscle atrophy and difficulty swallowing. Respiratory failure develops.

According to the clinical symptoms, it can be roughly divided into two types:

1.Limb-onset type.

Symptoms begin with progressive atrophy and weakness of the muscles in the limbs, and finally respiratory failure.

2.Bulbar onset.

Difficulty swallowing and speaking begins with early progression, and respiratory failure soon progresses.

In order to diagnose amyotrophic lateral sclerosis at an early stage, in addition to the neurological clinical examination, electromyography, nerve conduction velocity testing, serum special antibody testing, lumbar puncture cerebrospinal fluid examination, imaging examination, and even muscle biopsy are also required.

Diagnosis 1History and neurological examination.

The first important step in the diagnostic process is a clinical consultation with a neurologist. Collect a detailed history of present illness, family history, and work and environmental exposures. During the visit, the neurologist will look for typical findings of amyotrophic lateral sclerosis:

1) The examination should assess the strength of the chewing and swallowing muscles, including the mouth, tongue and throat muscles.

2) Lower motor neuron (LMN) function, such as muscle atrophy, muscle strength, or muscle beating (known as fasciculations).

and 3) upper motor neuron (UMN) function, such as tendon hyperreflexia and muscle spasms (degree of muscle tension and rigidity).

4) Emotional reactions are out of control, such as emotional changes such as crying or laughing. Changes in thinking, such as loss of judgment or loss of basic social skills. The examiner will also assess the patient's speech fluency and ability to recognize words. These symptoms are uncommon and not easily taken seriously.

5) The neurologist will also ask questions such as pain, sensory loss, or extrapyramidal problems.

ALS is amyotrophic lateral sclerosis. Amyotrophic lateral sclerosis presents primarily with skeletal muscle weakness, amyotrophy, fasciculations, bulbar palsy, and pyramidal signs.

ALS symptoms are mainly based on the clinical type. It can be divided into four types: 1. Progressive spinal muscular atrophy

The early symptoms are mainly symmetrical bilateral and thenar muscle atrophy and weakness. 2. Progressive bulbar palsy: its early symptoms mainly include unarticulation, hoarseness, heavy nasal voice, choking on drinking water, difficulty swallowing, salivation, tongue muscle atrophy and fasciculations.

3. Primary lateral sclerosis: its early symptoms are mainly weakness of both lower limbs, increased muscle tone, and spasmodic or scissor-like gait when walking. 4. Amyotrophic lateral sclerosis:

This type is the most common, and the early symptoms are clumsy and inflexible finger movements, inaccurate fine movements, and weakness.

ALS is more common in men aged 40-50 years old, and it is a rare disease that can cause muscle weakness, muscle atrophy and pyramidal tract signs. If the patient has a long onset of the disease, it will develop dementia and paresthesias, and even affect the movement of the limbs. Everyone should beware of the occurrence of ALS and popularize the symptoms of the disease, so what are the symptoms of ALS?

1. Muscle weakness and muscle atrophy.

Muscle weakness and muscle atrophy are the most obvious symptoms of ALS, which can lead to clumsiness and weakness in one or both finger movements, and severe atrophy of the small muscles of the hand after aggravation, especially the damage to the thenar muscles and muscles. With the prolongation of the onset time, the patient's hands appear in the shape of eagle claws, and will gradually extend to the forearm, upper arm and other parts, and then aggravate the patient's condition.

2. Fasciculation.

The affected parts will produce obvious symptoms of fasciculation, and will also affect the health of the palate, pharynx, larynx and other parts, all of which will produce different degrees of muscle atrophy and weakness, resulting in the patient's arthria, accompanied by dysphagia and decreased masticatory function. Due to the damage of the bilateral corticobulbar tracts, it is easy to produce pseudobulbar paralysis symptoms, and severe cases should seek medical attention immediately.

3. Pyramidal tract sign.

If ALS patients have a longer onset time, both upper limbs will also be affected, resulting in muscle contraction and hypotonia, but tendon reflexes are severely hyperactive. In general, patients do not have objective sensory disorders, but are prone to subjective sensory symptoms, such as numbness.

4. Other performances.

Only a few patients will have dementia or paresthesias, and in severe cases, their bladder and rectal function will be impaired to varying degrees, and sometimes memory will be affected, which will bring trouble to life and work.

The above four points are the common manifestations of ALS, the disease is particularly common, and the harm is more serious, after the onset of the disease can not delay the time of treatment, early medication can temporarily alleviate the patient's condition. However, for patients with severe limb damage, surgical treatment should be given, and corresponding training should be strengthened. In addition, adjust your mentality and arrange your diet reasonably during the onset of the disease.