[Sportschosun, Jang Jong-ho] Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig's disease, is a progressive neurodegenerative disorder.
As motor neurons that control muscle movement in the brain and spinal cord are gradually damaged, muscle strength in the arms and legs weakens. It can also affect speech, swallowing and breathing. The disease became widely known as Lou Gehrig's disease after the Major League Baseball player was diagnosed with it.
Early symptoms of ALS vary from patient to patient. Weakness in one hand can make it difficult to button clothes or use chopsticks, while weakness in the ankle may cause frequent falls or make climbing stairs difficult. Muscles may become thinner, and twitching under the skin can also appear. Some patients complain of slurred speech and difficulty swallowing, and in rare cases, shortness of breath may occur from the early stages.
The problem is that these symptoms are nonspecific at first. Weakness in the hands or feet is often mistaken for aging, fatigue, a herniated disc in the neck or lower back, or joint disease. If speech becomes slurred, other neurological disorders such as stroke may be suspected first. Because the symptoms progress slowly, patients may not notice the changes themselves, or they may delay visiting a hospital.
In fact, it can take a considerable amount of time from the first symptoms of ALS to a final diagnosis. According to some studies, it takes an average of about one year from the onset of the first symptoms to an accurate diagnosis. This is because the symptoms vary widely and other neurological and muscular disorders with similar signs must be carefully ruled out.
ALS cannot be definitively diagnosed with a single test. Doctors make a diagnosis by reviewing the patient's symptoms and disease progression, along with neurological examinations, electromyography, nerve conduction studies, blood tests, and brain and spinal Magnetic Resonance Imaging (MRI). Depending on the patient, genetic testing, respiratory function tests and swallowing assessments may also be needed.
Professor Baek Seol-hee of the Department of Neurology at Korea University Ansan Hospital said, "Early diagnosis means more than simply identifying the disease name sooner." She added, "If the diagnosis is delayed, the start of drug treatment, nutrition and breathing management, and rehabilitation therapy may also be delayed, so it is important not to miss the early symptoms."
ALS is still a rare, intractable disease with no cure. The drugs currently available in South Korea are Riluzole and Edaravone, and a targeted therapy, Tofersen, has recently been introduced for some patients with confirmed SOD1 gene mutations. However, whether the treatment can be used must be determined by a specialist based on the patient's genetic profile, overall condition and stage of disease progression.
In ALS treatment, multidisciplinary care is just as important as medication. As the disease progresses, patients need support not only for motor function but also for breathing, nutrition, swallowing, communication and emotional issues. Rehabilitation therapy to maintain muscle strength and walking ability, nutrition and swallowing management to prevent weight loss and aspiration pneumonia, and respiratory function assessments to detect weakening of the breathing muscles early must all be provided together.
When necessary, braces, mobility aids, noninvasive ventilation, cough-assist devices, gastrostomy tubes, and augmentative and alternative communication devices can be introduced at the appropriate time. These treatments help patients maintain independent daily life for as long as possible and reduce discomfort and complications that may arise during care. It is also important to address the caregiver's burden and psychological strain, and to support patients and families in discussing future treatment directions in depth.
Professor Baek explained, "ALS is a disease that is difficult to manage with just one medication or treatment from a single department." She added, "From the time of diagnosis, a multidisciplinary approach that systematically evaluates breathing, nutrition, movement and communication functions, and provides the necessary treatments at the right time, is very important for maintaining the patient's quality of life."
She also said, "If muscle weakness or speech and swallowing problems recur or gradually worsen over time, do not assume it is simply aging. You should see a neurologist." She added, "Starting treatment and care early based on an accurate diagnosis is important for both patients and their families."
Reporter Jang Jong-ho bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
