Early symptoms of amyotrophic lateral sclerosis

Written by Zhang Hui
Neurology
Updated on September 29, 2024
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Amyotrophic lateral sclerosis (ALS) refers to motor neuron disease, with patients initially showing mainly reduced hand strength and clumsy fine motor activities, such as difficulty and lack of agility when using a screwdriver. There may also be atrophy of small muscles, such as the interosseous muscles of the hand and the hypothenar muscles, which are commonly seen in clinical settings. Some patients may initially exhibit symptoms like unclear speech, articulation disorders, and coughing or choking while drinking, which are important to recognize. As the disease progresses, the patient's generalized weakness becomes more apparent, with noticeable fasciculations and significant muscle atrophy developing clinically.

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Written by Liu Hong Mei
Neurology
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How do people with ALS eat if they can't swallow?

Patients with amyotrophic lateral sclerosis (ALS) who no longer have swallowing function can be given nasogastric feeding and intravenous hyperalimentation to maintain nutrition and electrolyte balance. For patients with respiratory difficulties or respiratory failure, oxygen supplementation can be administered. This can be combined with treatments such as acupuncture, physical therapy, massage, and heat application. It is important to prevent complications such as pulmonary infections, aspiration pneumonia, hypostatic pneumonia, lower extremity venous thrombosis, acute gastritis, gastric mucosal erosion, and gastrointestinal bleeding, which are common in later stages of ALS. With the loss of swallowing function and decreased immunity, these complications can occur more frequently and require proactive treatment to improve nutritional status.

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Written by Liu Hong Mei
Neurology
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Do people with ALS experience frequent muscle twitching?

Muscle twitching in people with ALS (Amyotrophic Lateral Sclerosis) can be very frequent. When muscles in ALS patients experience spasms, irritation, weakness, or fatigue, twitching is likely to occur. Muscle twitching in ALS patients is generally very frequent and is related to the disease. ALS, often referred to as motor neuron disease, is caused by degenerative changes in the central nervous system, such as the spinal cord and brain, leading to damage in the neuromuscular system, resulting in muscle atrophy, twitching, and tremors. It is advisable to seek medical evaluation and, once diagnosed, pursue active treatment which may include nutritional support, massage acupuncture, and functional exercise.

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Written by Li Qiang
Intensive Care Unit
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Is it necessary to perform a tracheotomy in the late stages of ALS?

Patients in the late stages of amyotrophic lateral sclerosis (ALS) must undergo a tracheotomy because, by this stage, they have completely lost their motor abilities, including the muscle strength needed for breathing. Consequently, they lack the strength to breathe on their own, leaving them unable to survive without a ventilator. They must rely continuously on a ventilator to breathe as they cannot do it themselves. Therefore, if a ventilator is needed over the long term, a tracheotomy is necessary. This is because other methods, such as inserting tubes through the mouth or nose into the trachea to connect to the ventilator, are quite uncomfortable. Comparatively, tracheotomy offers a bit more comfort, making it a necessary procedure for connecting to a ventilator for long-term use and achieving greater comfort.

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Written by Liu Hong Mei
Neurology
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Do people with ALS feel soreness and pain in their legs when lying down?

People with ALS often experience soreness and pain in their legs when lying down. In patients with ALS, certain neurons in the brain and spinal cord gradually degenerate and die, leading to muscle atrophy, nerve damage, muscle weakness, and stiffness, as if they are frozen. This muscle damage can lead to symptoms such as sore legs, general weakness, and fatigue. Over time, it may also cause difficulties in walking, speaking, eating, choking while drinking water, swallowing, and breathing. This can lead to systemic damage, complications like breathing difficulties, respiratory failure, and ultimately threaten life. The symptoms of leg pain and soreness in people with ALS, when lying down, can be alleviated through acupuncture, physical therapy, massage, and heat application.

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Written by Liu Shi Xiang
Neurology
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Does amyotrophic lateral sclerosis cause leg soreness?

Patients with amyotrophic lateral sclerosis (ALS) may experience leg pain, but leg pain is not the primary clinical manifestation of ALS. The early main symptoms of ALS include muscle atrophy and limb weakness. As the disease progresses, patients will further experience general muscle atrophy and weakness, which may manifest as difficulty in swallowing, speech problems, and respiratory difficulties. As the disease progresses, if the patient experiences extreme muscle atrophy and limb weakness, they may experience leg pain during movement, but this symptom is not specific. Therefore, when symptoms such as muscle atrophy and limb weakness occur, the possibility of ALS should be considered, and patients need to undergo timely examinations such as electromyography and muscle biopsy to confirm the diagnosis. If the patient also suffers from leg pain, other conditions such as sciatica and osteoporosis should be considered, and further examinations like bone density tests and lumbar disc magnetic resonance imaging should be conducted to clarify the diagnosis.