There is no known cure to ALS and it can only be managed to relieve symptoms and extend life expectancy.
Riluzole
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The drug riluzole has been found to improve survival of ALS patients by several months. It is currently the only drug approved by the U.S. Food and Drug Administration (FDA) used to treat ALS. Riluzole selectively blocks tetrodotoxin-sensitive sodium channels associated with the damaged motor neurons (tetrodotoxin is a neurotoxin). These sodium channels transmit impulses in cell networks. Riluzole blocks sodium channels which are transmitting incorrect impulses or none at all. This allows the patient to generally increase their lifespan and delay the time before breathing support is needed.
Breathing Support
When muscles assisting the respiratory process weaken, a patient must use ventilatory assistance in order to survive. There are many different methods of breathing support, some of which are listed below:
- Mechanical ventilation - A method to assist/replace natural breathing. A medical ventilator or a physician may compress a bag/bellows, in order to pump air in and out of the lungs. The method used for treating ALS patients is positive pressure ventilation where the air is pushed into the trachea. If a mask is used to administer the mechanical ventilation, it is a non-invasive method of breathing support.
- Biphasic cuirass ventilation (BCV) - This is a non-invasive method of negative pressure ventilation (air is sucked into the lungs). The patient is required to wear an upper body shell which assists in breathing. This system depends on changing the pressure, from negative to positive, inside the shell during times of inspiration and expiration.
- Bilevel positive airway pressure (BPAP) - A form of non-invasive mechanical positive pressure ventilation support. It generates inspiratory and expiratory pressure gradients that are based on the patient's respiratory cycle. This allows for the respiratory system to optimize the lung's efficiency and reduces the work needed to breathe. The device used to administer this looks like a mask with a tube which is attached to a machine which monitors pressure levels.
Nutrition
Dieticians can help patients plan out a healthy lifestyle which provides them enough fiber and calories while still being easy to swallow. A suctioning device may need to be used if there are excess fluids or saliva present in the body to prevent choking. In the later stages of ALS, doctors may insert a feeding tube into the stomach of the patient to make sure the patient is receiving nourishment. Using a feeding tube also reduces the risk of pneumonia or choking caused from inhaling fluids into the lungs. Research has shown that ALS patients should be encouraged to consume lots of energy, calories, but many patients experience a severe loss of appetite.
Therapy
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Therapy is also used to manage ALS. Physical therapy is very important in delaying the loss of strength, maintaining endurance, preventing complications and limiting pain. Therapists can help patients set goals in order to lead a healthier life and suffer less from ALS. Therapists can also make use of assistive technology, like a wheelchair, to help their patients be safer and more independent.
In some cases, patients may have difficulty speaking. A speech-language pathologist can teach patients strategies to help them speak clearly and loudly. They can also recommend technology to help with speaking such as voice amplifiers and speech-generating devices.
In some cases, patients may have difficulty speaking. A speech-language pathologist can teach patients strategies to help them speak clearly and loudly. They can also recommend technology to help with speaking such as voice amplifiers and speech-generating devices.
End of life care
Social workers and home care nurses help those with ALS when they are in their final stages of the disease. They can arrange legal work such as preparing a living will or help financially. Home nurses also teach the guardians/caregivers of the patient how to maintain breathing support and give food. They can also help the patient live at home, if desired, near the end of his/her life with the highest quality of life possible.