Overview
ALS (Amyotrophic Lateral Sclerosis), also known as motor neurone disease, is a progressive condition in which nerve cells that control muscle movement gradually stop working and die. Over time this leads to increasing weakness of the arms, legs, speech, swallowing, and breathing.
How common is it?
ALS affects roughly 2 to 3 people per 100,000 each year. About 90% of cases occur with no clear family history.
Causes and risk factors
In most cases the exact cause is unknown. Nerve cells in the brain and spinal cord that control voluntary movement break down for reasons that likely involve a combination of genetic vulnerability and environmental triggers.
Common risk factors
- Age over 60
- Male sex (slightly higher risk)
- Family history of ALS
- Military service (possibly related to toxin exposure)
- Smoking
- Contact with heavy metals or pesticides (under investigation)
Symptoms
- Muscle weakness starting in one hand, arm, or leg
- Tripping or dropping things
- Slurred or slow speech
- Muscle cramps and twitching
- Difficulty swallowing
- Uncontrollable laughing or crying
- Breathing difficulties in later stages
When to see a doctor
See a neurologist promptly if you notice progressive muscle weakness, persistent muscle twitching, or changes in speech or swallowing that have no obvious explanation.
Diagnosis
There is no single test. Neurologists diagnose ALS by ruling out other conditions using nerve conduction studies, EMG (electromyography), MRI scans, and blood tests.
Treatments
Riluzole
The main disease-modifying drug approved for ALS. It slows progression modestly by reducing glutamate toxicity in nerve cells.
Edaravone
An antioxidant drug that may slow functional decline in some people, particularly those in early stages.
Supportive and palliative care
A team approach including physiotherapy, speech therapy, dietary support, breathing assistance, and psychological care to maintain quality of life at every stage.
Self-care and lifestyle
- Work with a speech therapist early to preserve communication and eating strategies
- Plan ahead for assistive technology such as voice amplifiers and communication devices
- Respiratory physiotherapy helps manage breathing as the disease progresses
- Psychological support for both the person and family carers is essential
Prevention
There is no known way to prevent ALS. Genetic counselling is available for the rare families with hereditary forms.