Amyotrophic Lateral Sclerosis (ALS / Lou Gehrig's Disease)
定义
Amyotrophic lateral sclerosis (ALS) is a disease of the nervous 系统. It leads to the damage of nerve cells in the brain and spine. 这些神经 control muscle movement. People with ALS have muscles that weaken and shrink as the disease gets worse.
| The Nervous System |
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原因
The exact cause is not known. Genes and the environment may play a role.
风险因素
ALS is more common in men and in people who are 50 to 75 years of age. Other things that may raise the risk are:
- Having a family member with ALS
- Having certain genetic changes
症状
The first symptoms of ALS may be:
- Changes in speech
- Tripping while walking
- Problems with fine motions like grasping a pen
Problems get worse over time and result in:
- Hoarseness and coughing
- 口齿不清
- Muscle twitching
- Weakness in the arms and legs
- Problems raising the hand or foot or holding things
- Problems chewing, swallowing, and weight loss due to trouble eating
- 流口水
- Problems breathing
- 情绪波动
诊断
The doctor will ask about symptoms and health history. 一个物理 exam will be done. There are no tests to diagnose ALS.
Tests will be done to rule out other health issues that cause similar problems. 这些可能是:
- Blood and urine tests
- Images of the brain and spine using:
- 腰椎穿刺—to look for changes in the fluid that surrounds the brain and spinal cord
- 活组织检查 to closely examine muscle and nerve tissue in a lab
- 肌动电流图—to look at problems with the connection between the nerves and muscles
The care team will look at a person's symptoms and test results before making a diagnosis. A second opinion with a doctor who focuses on nerves may help confirm the diagnosis.
治疗
The goal of treatment is to manage symptoms. There is no cure. Ways to do this are:
药物
Some medicines may help slow the disease. Others may be used to:
- 减轻疼痛
- Relax muscles that are in spasm
- Reduce heavy drooling
- Manage depression and anxiety
- Treat inappropriate laughter or crying
支持性护理
A team of specialists will work with a person to create a care 计划. The 计划 will focus on quality of life for the person and their family.
ALS will affect muscles throughout the body. 咀嚼, swallowing, speech, and breathing can all be affected. Care will help support the body when these changes occur. Ways to do this are:
- Physical therapy to ease muscle cramping and spasms
- Help with breathing, such as oxygen, breathing machines, or making an airway in the base of the neck
- Improving nutrition through supplements or a feeding tube
- Speech therapy to improve communication
- Mental health counseling and 支持团体 to help people with ALS and their family members cope with the stress of this health problem
预防
ALS cannot be prevented.
参考文献
- Amyotrophic lateral sclerosis. EBSCO DynaMed website. 可以在: http://www.力学.com/condition/amyotrophic-lateral-sclerosis-肌萎缩性侧索硬化症.
- Amyotrophic lateral sclerosis (ALS) fact sheet. 国家 Institute of Neurological Disorders and 中风 website. 可以在: http://www.研究所.国家卫生研究院.gov/amyotrophic-lateral-sclerosis-肌萎缩性侧索硬化症-fact-sheet.
- 布伦特,J.R. and Ajroud-Driss, S. Amyotrophic lateral sclerosis: Integrated care provides the best quality of life. Pract Neurol (Fort Wash Pa), 2019; 18: 46-49.
- 布伦特,J.R.弗朗茨，C.K.等。. ALS: management problems. Neurol Clin, 2020; 38 (3): 565-575.
- 什么是渐冻症? ALS Association website. 可以在: http://www.肌萎缩性侧索硬化症.org/aunderstanding-肌萎缩性侧索硬化症/what-is-肌萎缩性侧索硬化症.html.