There is a huge difference between detection and diagnosis. Detecting ALS can simply mean that you suspect that the symptoms displayed can be related a family of ailments one of which is ALS. Diagnosis is an advanced stage of detection. Diagnosis involves specific tests being conducted when there is more than 70% suspected probability that the patient is affected by ALS. Diagnosis is critical because only after a conclusive diagnosis can targeted medication & treatment for minimizing spread of ALS follow.
Early diagnosis is the best way to delay the progression of the disease. The initial symptoms of ALS are similar to those of any other motor neuron diseases which are curable. Hence, detection of the detection takes some time. No test can provide a definite diagnosis of ALS, although the presence of upper and lower motor neuron signs in a single limb is strongly suggestive. Doctor’s generally adopt the process of elimination and ruling out of other diseases which have similar symptoms. If all tests to those diseases turn negative, then possibility of the patient suffering from ALS is entertained.
Typical array of tests
Doctors often prescribe a number of tests and ask them to be repeated after a period of time to understand the pattern of the symptoms
The tests that doctors prescribe to rule out other conditions include:
• Electromyogram (EMG)
• Nerve Conduction study
• Magnetic resonance imaging
• Blood and urine tests
• Spinal tap
• Muscle biopsy
When all these tests suggest that no other cause for the symptoms, doctors may diagnose ALS. Thus, ALS is a disease whose cause is still undiagnosed. The spread of the disease is gradual and steady with greater disabling symptoms. But it doesn’t affect the intellect of the patient or his or her personality. It is always better to go for early detection because the sooner the disease is detected the greater is the possibility of application of drugs to retard the progression and the disease and lead a somewhat more functional and healthy life.
The manifestation of ALS depends on which part of the nervous system is affected. About 2/3rd of patients may have typical or spinal form ALS and experience focal muscle weakness of distal or proximal upper or lower limbs. There is spread of weakness to contiguous muscles in the same region before another region is involved. Some patients may have weakness in both the distal lower limbs. Approximately 25% of patients have difficulty is speaking and making clear articulation. With time it turns into slurred and nasal speech. Theyalso find it difficult to chew or swallow. Head drop may be the initial manifestation of the disease in the small minority of patients.
The Unaffected Organs
Even in the late stages of the illness, sensory, bladder, bowels and cognitive functions are not affected. patients have fully functioning brains. A typical patient’s intelligence, personality and intelligence remain unaffected.Even the ocular or eye movement remains unaffected until the very late stage of the disease. The best example of this was renowned scientist Stephen Hawkins, who despite being a patient of ALS continued his scientific research and kept on contributing to the literature of physics.
ALS progresses slowly to impair the patient’s ability to lead a normal life. If you ride bikes, you may find it difficult to maintain the control over the machine due to muscle twitching in arms, legs and shoulder. If you are into teaching or making corporate presentation, you may feel uncomfortable while talking. Or, you may become overly forgetful.
However, it is suggested not to panic if any of these symptoms arise. There could be many other reasons for such symptoms apart from ALS. The objective is to make you aware of the signs and symptoms of the disease so that anyone facing any of the abovementioned difficulties can immediately seek doctor’s advice and go for several medical tests to detect the cause of the symptoms.