To find out if you have ALS, your doctor will do a physical exam and will ask you about your symptoms and past health. You will also have tests that show how your muscles and nerves are working." (WebMD, 1) These tests may given the physician cause to observe the nerve cells where atrophy has occurred. Because ALS will generally prove debilitating to both upper and lower motor neurons, symptoms demonstrating a degeneration in both capacities will frequently be a tip-off that ALS is present.
Host/Intermediate host or Life
The individual who is host to this condition will have a limited life expectancy. ALS is a fatal disease which may run its course in a period of months or over a number of years. But as with the namesake of the condition in the U.S., Lou Gehrig, even those in peak physical condition may be struck by an aggressive advancement of the condition. Gehrig only survived two years following his diagnosis. This is demonstrative of the life-cycle for a disease that works its way through the body, eventually resulting in the failure to control basic life functions. According to current research "there is no cure for ALS, but treatment can help you stay strong and independent for as long as possible. It can also help you avoid other problems from ALS." (WebMD, 1)
Pathogenicity (include the pathology of the disease, specific toxins or other chemicals involved in the making of the disease)
Though the immediate effects of ALS become first present through the function of extremities, the pathogenicity of the disease demonstrates that an array of bodily systems are impacted and will produce evidence of the disease. Particularly, Waller (2006) indicates that "atrophy of the anterior horn cells and replacement of the large motor neurons by fibrous astrocytes (gliosis) causes the affected anterior and lateral columns of the spinal cord to become hard, hence the term 'lateral sclerosis.' Large neurons tend to be affected before small ones, but the general distribution of pathologic findings within the spinal cord should correlate with the clinical findings." (Waller, 1) This is also true of the brain, which will demonstrate atrophy in the motor cortex. In some ways, the pathology of the condition demonstrates the way that it invades and permeates the whole of the central nervous system.
In addition to the toxins which are found in the body due to the failure of the body to produce certain needed enzymes, we may also suggest the possibility that exposure to such chemicals as pesticides and chemical-based military weaponry could also be associated with ALS.
Diagnostic tests and treatment.
The first step in diagnosis is consultation with the physician. But subsequent to this, muscle testing such as the EMG are used in order to assess the extent of the damage present in the patent. According to Reichenberg, "the EMG will demonstrate damage due to LMN loss in the weakened muscles and may also show changes in muscles that are still strong. NCV should be normal. However, these studies are important because they help to detect motor neuropathy with or without conduction block in people with mainly LMN damage." (Reichenberg, 1)
This can also help to direct the treatment process. Though most individuals diagnosed with the disease will not survive for more than a few years, identifying motor neuropathy can help to provide focus for physical therapy. Patients can use properly guided exercises to retain strength as long as possible as well as to extend life and preserve physical comfort. Additionally, there are several drug treatment paths, but most of these are based on the extremely limited etiologic findings available to us, meaning that such approaches have been modestly successful at best. The most commonly employed treatments for ALS are those which work toward pain management and minimization.
Aebischer, P. & Kato, a.C. (2007). Playing Defense Against Lou Gehrig's Disease. Scientific American.
Ray, S.S. & Lansbury, P.T. (2004). A Possible Therapeutic Target for Lou Gehrig's Disease. Proceedings of the National Academy of Sciences of the United States of America, 101(16), 5701-5702.
Reichenberg, E. (2008). Understanding ALS. ALS Hope Foundation.
Walling, a.D. (2006). Amyotrophic Lateral Sclerosis: Lou Gehrig's Disease. American Academy of Family Physicians.