The 3 Phases Of Amyotrophic Lateral Sclerosis (ALS)
Amyotrophic lateral sclerosis (ALS) is a disease that affects the brain and spinal cord, causing a gradual loss of muscle function and control. The abilities to walk, talk and swallow are progressively impaired to the point of being lost completely.
ALS is a disease whose exact causes are still unknown, but it has multiple contributing factors: genetic and environmental. Although there is currently no known cure, there are therapies that can help people diagnosed with ALS live longer and improve their quality of life.
There are two main types of ALS whose symptoms manifest through specific phases. In this article we will talk in detail about the different stages of ALS as a pathology that develops its symptoms as time passes.
Amyotrophic lateral sclerosis is a degenerative disease that attacks the nervous system and produces the progressive loss of motor functions Worldwide, the prevalence of ALS is 5 in every 100,000 people, which is why it is considered a rare disease.
It is a progressive disease, but the progression of symptoms can differ between people. Nerve cells called motor neurons or motoneurons control the voluntary muscle actions of different parts of the body, such as the arms, legs and face, and ALS affects these nerve cells, which progressively lose their function and finally die. So, messages sent through motor neurons stop being sent and the brain’s ability to control voluntary movement is lost. Over time, when not used, muscles begin to degenerate and become weaker.
Although progressive muscle weakness is a symptom that appears in all patients diagnosed with ALS, this may not be the first sign or indication of the disease.
The progression of the disease varies from person to person, and the beginnings of the disease can be difficult to notice, as no manifestation is perceived. As time passes, the signs and symptoms of the disease become more evident. Some of the first visible symptoms include clumsiness, unusual tiredness in the extremities, muscle cramps and spasms, and difficulty speaking. Symptoms spread to the entire body as the disease progresses.
Brain function deteriorates over time, and in some people with ALS this can lead to a form of dementia, known as frontotemporal dementia. Additionally, people’s decisions and memories may also be compromised as the disease progresses. In terms of psychological functions, the emotional lability that results from the disease can also cause people to have more variable moods and emotional responses.
Phases of ALS
There is no cure for ALS. The average lifespan of a patient with ALS is 3 years after diagnosis. 20% will live 5 years and 10% 10 years. Only 5% of people with ALS live 20 years or more. Most diagnosed patients die within 2 to 10 years after diagnosis due to respiratory failure resulting from progressive loss of function
There is no official definition of the stages of ALS, as the disease progresses differently for each patient. Some people experience different symptoms at different times, and the progress of the condition and its consequences is variable, with some people losing function more quickly than others. Having said that, Broadly speaking, ALS can be divided into three stages: early, intermediate, and late
early stage
Although there are cases of early onset, the average age of onset of the disease is 50 years. The disease initially progresses slowly and often causes no pain which can cause patients to delay visiting the doctor for a long time.
If the first symptoms affect the patients’ speech or ability to swallow, it is called “bulbar-onset ALS.”
If the hands and feet are affected first and abnormal muscle movements occur, it is known as “extremity-onset ALS.”
Sometimes the disease begins with a loss of body weight or muscle mass, or abnormal breathing. About 3% of patients experience respiratory problems as their first symptom.
At first, people typically experience muscle weakness, stiffness, and cramps As there is no linear progression of the disease, some people may present more symptoms than others. People may be unable to perform everyday tasks as the symptoms affect the muscles: ALS patients may fall, drop things, or be unable to button their shirt.
ALS is a variable disease in its development. Sometimes the progression is slow, occurs over years, and has periods of stability with different levels of disability. Other times it is rapid and there are no stable periods.
During this stage of ALS, different symptoms can be experienced: difficulty swallowing and breathing. Muscles can become paralyzed, muscle loss is experienced, and muscles may even become shorter Joints lose movement, speech slows, and patients may laugh or cry in ways they cannot control.
Speech, swallowing and breathing are ultimately affected by the disease: ALS patients often show signs of bulbar involvement when weakness and paralysis extends to the muscles in the trunks of their bodies.
The patient may lose the ability to speak completely and have difficulty swallowing, and a reduced ability to cough. These problems put patients at risk of suffering from different respiratory problems (asphyxiation, respiratory infection, pneumonia) and malnutrition.
As the disease progresses, the muscles used for breathing can deteriorate and lose function, requiring the patient to be on a ventilator for life.
The muscle changes that a person may experience during the early phases of ALS may worsen during the middle phases of the disease. This means that the symptoms can also affect other parts of the body. Patients increasingly need help to carry out daily activities as the disease enters this phase.
The patient will be treated by multiple specialized teams. Today, pulmonology has made great advances, which can help the patient’s quality of life in this stage of ALS.
Later stages
Over time, the patient becomes fully aware of his illness and its progression. This awareness often causes psychological problems related to fear of dying and physical disability The patient may be dealing with anxiety or depression. Quality of life is one of the main objectives of ALS treatment, since the patient and her family have to face all aspects of the disease together.
When the patient has ALS, they become completely dependent on others. Patients and their families must face all phases of the disease with the help of specialized professionals.
When a person reaches the later stages of the disease, all of their muscles begin to paralyze, including those in the throat and mouth. This makes it impossible to talk, eat or drink. A tube may be needed to provide food and drink to the person
The patient may also develop the following complications: respiratory failure, malnutrition and pneumonia.
Some people who have ALS also develop frontotemporal dementia (FTD), while others who are initially diagnosed with FTD develop ALS symptoms. FTD is also a progressive disorder that affects speech, behavior, and personality.
Conclusion
ALS is a disease that affects the neurons that control movements and produces the progressive loss of motor functions.
There is no cure for ALS, it is considered a progressive disease. Although its stages are not officially defined, since it is a quite variable disease in the appearance of symptoms and its development.
Broadly speaking, amyotrophic lateral sclerosis can be divided into three stages. In the early stages it may cause muscle spasms or weakness. In the later stages there may be paralysis, breathing problems or loss of muscle mass. The most common cause of death is respiratory failure resulting from loss of function.
People with ALS can improve their lives by using different treatment options that also include mental health support.
