Bass symptoms at a young age. Bass diagnosis is there any recovery

Amyotrophic lateral sclerosis (ALS, "Hehrig's disease", "motor neuron disease") was first described by the French psychiatrist Martin Charcot in 1869.

In the US and Canada, there is another term - "Lou Gehrig's disease", a famous baseball player who had to end his career at the age of 36 due to amyotrophic lateral sclerosis.

What is amyotrophic lateral sclerosis?

Amyotrophic lateral sclerosis is a nervous system disease that rapidly affects the motor neurons of the spinal cord, brainstem, and cortex.

IN pathological process the motor nerves of the cranial neurons (facial, ternary, glossopharyngeal) are involved.

Amyotrophic lateral sclerosis is rare (2-3 people per 100,000) and progresses rapidly.

In medicine, there is another concept - the syndrome of amyotrophic lateral sclerosis. It is provoked by another disease, so the treatment in this case is aimed at eliminating the underlying pathology. If a patient has symptoms of ALS, but their causes are not known, doctors are not talking about the syndrome, but about the disease.

In ALS, motor neurons are destroyed, they stop sending signals from the brain to the muscles, as a result, the latter begin to weaken and atrophy.

Causes

The reasons that provoke the appearance of this disease have not yet been established. However, scientists offer several theories:

hereditary

It has been established that in 10-15% of cases the disease is hereditary.

Viral

This theory has received wide use in the 60s of the 20th century in the USA and the USSR. At this time, experiments were carried out on monkeys. Animals were injected with extracts of the spinal cord of sick people. It was also assumed that the disease can be provoked by the polio virus.

Gennaya

Gene disruption is found in 20% of patients with ALS. They encode the enzyme Superoxide dismutase-1, which converts Superoxide, which is dangerous for nerve cells, into oxygen.

autoimmune

Scientists conducted research and found antibodies that kill motor nerve cells. It has been proven that these antibodies can be formed when serious illnesses(Hodgkin's lymphoma, lung cancer, etc.).

neural

This theory was developed by British scientists who believe that the formation of ALS can provoke elements of glia - cells responsible for the vital activity of neurons. If the function of astrocytes that remove glutamate from nerve endings, the risk of Charcot's disease increases several times.

Among the risk factors, doctors distinguish: hereditary predisposition, age over 50, smoking, lead-related work, and military service.

ALS symptoms

Regardless of the form of the disease, all patients feel muscle weakness, muscle twitches appear, and muscle mass decreases.

Muscle weakness increases rapidly, but eye muscles and sphincter Bladder are not affected.

On early stage disease occurs:

• muscle weakness in the ankles and feet;
• hand atrophy;
• impaired motor skills and speech;
• difficulty in swallowing;
• muscle twitching;
• spasms of the tongue, arms and shoulders.

With the development of ALS, bouts of laughter and crying appear, balance is disturbed, atrophy of the tongue appears.

Cognitive functions worsen only in 1-2% of cases of the disease; in other patients, mental activity does not change.

In the later stages, the patient develops depression, interruptions in breathing begin, and the ability to move independently is lost.

Patients with ALS cease to be interested in their loved ones and the outside world, they become capricious, unrestrained, emotionally labile and aggressive. When the respiratory muscles stop working, the person needs mechanical ventilation.

Course of the disease

Initially, symptoms appear that prevent a person from leading full life: muscle numbness, convulsions, twitching, difficulty speaking. But, as a rule, at the very beginning it is difficult to determine the exact cause of these disorders.

In most cases, ALS is staged muscular atrophy.

Gradually, muscle weakness spreads and covers new parts of the body, the patient cannot move independently, breathing problems begin.

Patients with ALS rarely suffer from dementia, but their condition leads to severe depression in anticipation of death. At the last stage, a person can no longer eat, walk and breathe on his own, he needs special medical devices.

Forms of the disease

Forms of the disease are distinguished by the location of the damaged muscles.

Bulbarnaya

The cranial nerves are affected (9,10,12 pairs).

Patients with the bulbar form of ALS begin to have problems with speech, they complain of difficulty in pronunciation, it is difficult for them to move their tongue.

With the progression of the disease, the act of swallowing is disturbed, food can pour out through the nose. On late stage diseases, the muscles of the face and neck completely atrophy, facial expressions disappear, patients with ALS cannot open their mouths and chew food.

cervicothoracic

The disease progresses in the upper limbs on both sides.

Initially, discomfort in the hands appears, it becomes difficult for a person to perform complex movements with his hands, write, play musical instruments. On examination, the doctor notices that the muscles of the patient's arms are tense, and tendon reflexes are increased.

In the advanced stages of the disease, muscle weakness progresses and spreads to the forearms and shoulders.

lumbosacral

The first symptom is weakness in the lower extremities.

It becomes more difficult for the patient to do work while standing, climb stairs, ride a bicycle and walk long distances.

Over time, the foot begins to sag, the gait changes, then the leg muscles completely atrophy, the person cannot walk, urinary and fecal incontinence develops.

Almost 50% of patients suffer from the cervicothoracic form of ALS, 25% each are lumbosacral and bulbar.

Diagnostics

The neurologist uses as the main diagnostic methods:

MRI of the brain and spinal cord

Using this method, it is possible to detect degeneration of pyramidal structures and atrophy of the motor parts of the brain.

Neurophysiological examinations

To detect ALS, TKMS (transcranial magnetic stimulation), ENG (electroneurography), EMG (electromyography) are used.

Cerebrospinal puncture

The level of protein content (normal or elevated) is determined.

Biochemical blood tests

In patients with ALS, an increase in creatine phosphokinase by 5 or more times, accumulation of creatinine and urea, and an increase in AST and ALT are found.

Molecular genetic analysis

The gene encoding Superoxide dismutase-1 is being investigated.

But these methods are not enough to identify the diagnosis, in parallel used differential diagnosis to confirm or exclude diseases:

• brain: dyscirculatory encephalopathy, tumors of the posterior cranial fossa, multisystem atrophy.
• spinal cord: tumors, syringomyelia, lymphocytic leukemia, spinal amyotrophy etc.
• muscles: myositis, oculopharyngeal myodystrophy, myotonia Rossolimo-Steiner-Kurshman.
• peripheral nerves: multifocal motor neuropathy, Parsonage-Turner syndrome, etc.
• neuromuscular synapse: Lambert-Eaton syndrome, myasthenia gravis.

Treatment

There is no cure for ALS, but it is possible to slow the progression of this disease, increase life expectancy and alleviate the condition of a person.

For this, complex therapy is used:

The drug, which was first used in the treatment of ALS in the UK and the USA. Active substances block the release of glutamine and slow down the process of neuronal damage. The drug must be taken 2 times a day for 0.05 g.

Muscle relaxants and antibiotics help with muscle weakness. To eliminate muscle spasms and twitches, Mydocalm, Baclofen, Sirdalud are prescribed.

For increase muscle mass anabolic "Retabolin" is used.

Antibiotics if sepsis develops or infectious complications occur. Doctors prescribe fluoroquinolones, cephalosporins, carbopenes.

vitamins groups B, E, A, C to improve the impulse along the nerve fibers.

Anticholinesterase drugs, which slow down the process of destruction of acetylcholine ("Kalimin", "Prozerin", "Pyridostigmine").

In some cases, it is used stem cell transplant. It prevents the death of nerve cells, promotes the growth of nerve fibers and restores neural connections.

In the later stages, use antidepressants and tranquilizers, painkillers nonsteroidal drugs and opiates.

If sleep is disturbed, benzodiazepine preparations are prescribed.

To facilitate movement, chairs and beds with various functions, canes, fixing collars. Doctors advise speech therapy. In the later stages of the disease, a saliva ejector will be needed, and then a tracheostomy so that the patient can breathe.

Non-traditional methods of treatment for ALS do not give a positive result.

Forecast and consequences

Prognosis for ALS patients adverse. Death occurs after 2-12 years, as severe pneumonia develops, respiratory failure or other serious illness caused by Gehrig's disease.

With the bulbar form and in elderly patients, the period is reduced to 3 years.

Prevention

Measures to prevent ALS medicine are still unknown.

The disease progresses very quickly, there are no cases of successful treatment and restoration of the motor functions of the body. muscle weakness, which grows gradually, completely changes the life of a person and his family.

But despite the disappointing prognosis and insufficient study of the disease, loved ones should hope that effective treatments will be developed in the near future. therapeutic methods treatment. In the meantime, it is necessary to take measures to alleviate the condition of a person with ALS.

amyotrophic lateral sclerosis - dangerous disease that can immobilize a person and lead to death.

Doctors still cannot establish the exact causes of the disease and find effective methods treatment. On this moment, all that medicine can do is to alleviate the condition of patients with ALS. Not a single patient could completely recover from this disease. It is important to distinguish "ALS disease" from "ALS syndrome". In the second case, the prognosis for recovery is much better.

Reference. In addition to amyotrophic lateral sclerosis, the group of slow infections of the CNR includes such rare diseases as spongiform encephalopathies, kuru, or "laughing death", Gerstmann-Streusler disease, amyotrophic leukospongiosis, Van Bogart's subacute sclerosing panencephalitis.

The lethality of the disease will depend on the stage of progression. Despite the large amount of damage to the body, amyotrophic lateral sclerosis does not affect the mental abilities of a person.

Disease classification

The disease is divided into the following forms:

• sclerosis that occurs in the lumbosacral region;
• cervicothoracic lesion;
• damage to a peripheral neuron in the brain stem, referred to in medicine as a bulbar species;
• damage to the central motor neuron.

It is also possible to divide amyotrophic lateral sclerosis into types according to the rate of development of the disease and the presence of certain neurological symptoms.

1. With the Marian form, the symptoms of the disease appear early, but the course of the disease is slow.
2. Sporadic or classic ALS is diagnosed in most patients. The disease develops according to the standard scenario, the rate of progression is average.
3. Charcot's disease family type It is characterized by a genetic predisposition, and the first symptoms appear rather late.

Causes of amyotrophic lateral sclerosis

The disease develops due to the death of motor neurons. It is these nerve cells that control the motor ability of a person. As a result, there is a weakening muscle tissue and its atrophy.

Reference. In 5-10% of cases, ALS can be transmitted at the genetic level.

In other cases, amyotrophic lateral sclerosis occurs spontaneously. The disease is still being studied, and scientists can name the main causes of ALS:

Who can develop this disease, this is evidenced by risk factors:

• • 1. 10% of ALS patients inherited the disease from their parents.
    2. Most often, the disease affects people aged 40 to 60 years.
    3. Men are diagnosed with the disease more often.

Factors external environment, which increase the risk of developing amyotrophic lateral sclerosis:

• • 1. According to statistics, ALS patients were active smokers in the past, so people who smoke increased risk of developing the disease.
    2. Penetration of lead vapors into the body when working in hazardous industries.

Symptomatic manifestations

Any form of Charcot's disease has common unifying features:

• • • the organs of movement cease to function;
    • there are no disturbances in the sense organs;
    • defecation and urination occur normally;
    • the disease progresses even with treatment, over time the person becomes completely immobilized;
    • at times there are convulsions, accompanied by severe pain.

The role of neurology in diagnosis

As soon as a person notices changes in the muscle system, you should immediately contact a neurology specialist with a neurologist. Unfortunately, the diagnosis of amyotrophic lateral sclerosis in the early stages of the disease is not often made. Only after a certain period of time can one accurately name this particular disease.

The task of the neurologist is to collect a detailed medical history of the patient and his neurological status:

• • 1. Reflexes appear.
    2. The strength of muscle tissues.
    3. Muscle tone.
    4. visual and tactile status.
    5. Movement coordination.

On early stages The symptoms of ALS are similar to those of other neurological disorders. The doctor will refer the patient, first of all, to the following research methods:

• • 1. Electroneuromyography.
    2. Magnetic resonance imaging.
    3. Study of urine and blood. This method allows you to exclude the presence of other diseases.
    4. A biopsy of muscle tissue is performed in order to exclude muscle pathologies.

There is no specific therapy for the disease. ALS has a significant difference from similar disease – multiple sclerosis. Amyotrophic lateral sclerosis does not proceed in stages of exacerbation and remission, but is characterized by a steadily progressive course.

The human nervous system is very vulnerable. That is why there are many various diseases that can affect this particular part of the body. In this article I would like to talk about what is ALS (disease). Symptoms, causes of the disease, as well as methods of diagnosis and possible treatment.

What is this?

At the very beginning, you need to understand the basic concepts. It is also very important to understand what ALS (disease) is, the symptoms of the disease will be discussed a little later. Deciphering the abbreviation: atrophic lateral sclerosis. This disease affects nervous system a person, namely, motor neurons suffer. They are located in the cerebral cortex and in the anterior horns of the spinal cord. It is also worth mentioning that this disease It has chronic form and, unfortunately, is currently incurable.

Types

There are also three types of ALS disease:

1. Sporadic, classic. Not inherited. It accounts for approximately 95% of all cases of morbidity.
2. Hereditary (or family). As it has already become clear, it is inherited. However, this type of disease is characterized by a later manifestation of the first symptoms.
3. Guam-type or Mariana form. Its feature: it appears earlier than the two above. The development of the disease is slow.

First symptoms

It is worth saying that the first symptomatology of this disease may also apply to other other diseases. This is precisely the insidiousness of the problem: it is almost impossible to diagnose it immediately. So, ALS has the following symptoms:

1. Muscle weakness. It mainly concerns the ankles and feet.
2. Atrophy of the arms, weakness of their muscles. Dysmotility may also occur.
3. In patients at an early stage of the disease, the foot may sag slightly.
4. Characterized by periodic muscle spasms. Shoulders, arms, tongue may twitch.
5. The limbs are weakened. The patient has difficulty walking long distances.
6. The occurrence of dysarthria is also characteristic, i.e. speech disorder.
7. There are also initial difficulties with swallowing.

If a patient has ALS (disease), symptoms will develop and increase as the disease progresses. Further, the patient may periodically feel causeless fun or sadness. Atrophy of the tongue and imbalance may occur. All this happens because a person suffers from higher mental activity. In some cases, before the main symptomatology appears, the cognitive functions. Those. dementia appears (this happens infrequently, in about 1-2% of cases).

Development of the disease

What else is important to know for people who are interested in ALS (disease)? Symptoms that occur in a patient as the disease develops can tell what kind of disease he has:

1. ALS limbs. First of all, the legs are affected. Further, the dysfunction of the limbs progresses.
2. Bulbar ALS. In this case, the main symptoms are impaired speech function, as well as problems with swallowing. It is worth saying that this species disease is much less common than the first.

Increase in symptoms

What should a patient who has a disease like ALS know? Symptoms will gradually increase, the functionality of the limbs will decrease.

1. Gradually, pathological will occur when the upper motor neurons are affected.
2. Muscle tone will be increased, reflexes will be enhanced.
3. Gradually, the lower ones will also be affected. In this case, the patient will feel involuntary twitching of the limbs.
4. At the same time, quite often, sick people develop depression, there is a blues. All because a person loses the ability to exist without anyone's help, the ability to move is lost.
5. With ALS, the symptoms also concern the patient, interruptions in breathing begin.
6. Self-catering also becomes impossible. The patient is often inserted into a special tube through which a person receives all the food necessary for existence.

It is worth saying that ALS can occur quite early. Symptoms in young age will not differ from the symptoms of the patient, in whom the first signs appeared much later. It all depends on the body, as well as on the type of disease. With the development of the disease, a person gradually becomes disabled, loses the ability to exist independently. Over time, the limbs completely fail.

Last stage

On final stages the patient's disease is often disturbed respiratory function possible failure of the respiratory muscles. In such cases, patients need ventilation. May develop over time drainage function of this organ, which often leads to the fact that a secondary infection joins, which further kills the patient.

Diagnostics

Having considered such a disease as ALS, symptoms, diagnosis - that's what I also want to talk about. It is worth saying that this disease is detected most often by excluding other problems with the body. In this case, the following can be prescribed to the patient:

1. Blood analysis.
2. muscle biopsy.
3. X-ray.
4. Tests to determine muscle activity.
5. CT, MRI.

Differentiation

It is worth saying that this disease has symptoms that are manifested in other diseases. That is why it is necessary to differentiate ALS with the following problems:

1. Intoxication with mercury, lead, manganese.
2. Guienne-Bare syndrome.
3. Malabsorption syndrome.
4. Endocrinopathy etc.

Treatment

After a little consideration of such a disease as ALS, symptoms, treatment - that's what you also need to pay attention to Special attention. As already mentioned above, it is impossible to completely recover. However, there are drugs that help slow down the course of the disease. In this case, patients most often take such medications, as "Riluzol", "Rilutek" (daily twice a day). This drug able to slightly prevent the release of glutamine, a substance that attacks motor neurons. However, it will also be useful various methods therapy, the main objective which - the fight against the main symptoms:

1. If the patient is depressed, he may be prescribed antidepressants, tranquilizers.
2. At muscle spasms It is important to take muscle relaxants.
3. If necessary, anesthesia can be prescribed, at a late stage of the disease - opiates.
4. If the patient has disturbed sleep, benzodiazepine preparations will be needed.
5. If there are bacterial complications, you will need to take antibiotics (in ALS, bronchopulmonary diseases often occur).

Auxiliary means:

1. speech therapy.
2. Saliva ejector or taking a drug such as Amitriptyline.
3. Tube feeding, diet.
4. The use of various devices that can ensure the movement of the patient: beds, chairs, canes, special collars.
5. May need artificial ventilation lungs.

Facilities traditional medicine, acupuncture in this disease are useless. It is also worth mentioning that not only the patient, but also his relatives often need the help of a psychotherapist.

Symptoms of amyotrophic lateral sclerosis Simply put - from our experience - it's worth thinking about when growing weakness continues with burriness, begins to drag foot or plates in the kitchen begin to beat en masse, falling out of hands. Attention - all this is not always ALS - you may just experiencing a lot of stress and nervous strain! “Symptoms of amyotrophic lateral sclerosis are lower motor neuron symptoms, including weakness, atrophy, cramps and fasciculations, and symptoms of damage to the cortico-spinal tract - spasticity and increased tendon reflexes with pathological reflexes in the absence sensory disturbances. Corticobulbar tracts may be involved amplifying the already developed disease at the level of the brain stem. Amyotrophic lateral sclerosis is a disease of adults and does not begin in persons under 16 years of age. The most important clinical marker initial stages amyotrophic lateral sclerosis is an asymmetric progressive muscular atrophy with hyperreflexia (as well as fasciculations and cramps). The disease may begin with any striated muscle. Allocate high (progressive pseudobulbar palsy "), bulbar (“progressive bulbar paralysis”), cervicothoracic and lumbosacral forms). Death is usually associated with involvement of the respiratory muscles after about 3-5 years. The most common symptom of amyotrophic lateral sclerosis, occurring in about 40% of cases, is progressive muscle weakness upper limb, usually starting with the hand (starting proximally located muscles reflects a more favorable variant of the disease). If the onset of the disease is associated with the appearance of weakness in muscles of the hand, then thenar muscles are usually involved in the form of weakness of adduction (adduction) and opposition thumb. This makes it difficult to grasp large and index finger and leads to impaired fine motor control. The patient feels difficulty picking up small items and dressing (buttons). If the dominant hand is affected, then progressive difficulty in writing, as well as in everyday household activities. In the typical course of the disease, there is a steadily progressive involvement of other muscles of the same limb and then spread to the other hand before being affected lower limbs or bulbar muscles. Illness can begin with the muscles of the face or mouth and tongue, with the muscles of the trunk (extensors suffer more than flexors) or lower extremities. At the same time, the involvement of new muscles never “catches up” with those muscles from which the disease began. Therefore the shortest life expectancy is observed with the bulbar form: patients die from bulbar disorders staying on your feet (patients do not have time to live to paralysis in the legs). Relatively favorable shape - lumbosacral. In the bulbar form, one or another combination of symptoms of bulbar and pseudobulbar palsy, What manifested mainly by dysarthria and dysphagia, and then by respiratory disorders. characteristic symptom almost all form of amyotrophic lateral sclerosis is early rise mandibular reflex. Dysphagia when swallowing liquid food more common than solids, although swallowing solids as the disease progresses makes it difficult. Weakness of the masticatory muscles develops, the soft palate hangs down, the tongue in the oral cavity is motionless and atrophic. There is anartria, continuous flow of saliva, inability to swallow. Increased risk of aspiration pneumonia. It is also useful to remember that cramps (often generalized) occur in all patients with ALS and are often the first a symptom of the disease. It is characteristic that atrophies throughout the course of the disease are clearly selective. Tenar is affected on the hands, hypothenar, interosseous muscles and deltoid; on the legs - the muscles that carry out the dorsiflexion of the foot; in the bulbar musculature - the muscles of the tongue and soft palate. Most resistant to damage in amyotrophic lateral sclerosis oculomotor muscles. sphincter disorders are considered rare in this disease. Another intriguing feature of amyotrophic lateral sclerosis is absence of bedsores even in patients who are paralyzed and bedridden (immobilized) long time. Known also that dementia is rare in amyotrophic lateral sclerosis (with the exception of some subgroups: familial forms and in the complex "parkinsonism-ALS-dementia" on the island of Guam). Forms are described with uniform involvement of the upper and lower motor neurons, with a predominance of damage to the upper (pyramidal syndrome with "primary lateral sclerosis") or lower (anterohorn syndrome) motor neuron. Among paraclinical studies, the most significant diagnostic value has electromyography. Revealed widespread damage to the cells of the anterior horns (even in clinically intact muscles) with fibrillations, fasciculations, positive waves, changes in the potentials of motor units (their amplitude and duration increase) with normal speed conduction of excitation along the fibers of sensory nerves. The content of CPK in plasma can be slightly increased." (http://ilive.com.ua/)

The disease with this complex name has a short abbreviation ALS and refers to neurodegenerative diseases. This is one of the forms of deformation of neurons responsible for motor functions. In this disease, motor neurons located in the spinal cord, and in the head cortex. The course of lesions is irreversible, but their manifestations can be slowed down and partially stopped. In order to start the fight against the disease in time, when it has not yet passed into the stage of the patient's disability, it is necessary to know its symptoms and apply for specialized care as soon as possible.

Amyotrophic Lateral Sclerosis (ALS) - slowly progressive, incurable degenerative disease central nervous system

Before listing all the symptoms in detail this disease and give a detailed description of them, a warning should be given. No patient diagnosed with ALS has all possible symptoms simultaneously. Also, the order of their occurrence is not respected, they arise without any logical consequence. Also, it is not at all necessary one of the symptoms inherent in amyotrophic lateral sclerosis will point to this disease. It may be a sign of another disease. At the same time, the patient may experience signs of ALS that are not listed in the list of symptoms, individual deviations of a different nature.

If you want to know in more detail what it is, as well as consider the causes, symptoms, diagnosis and treatment of the disease, you can read an article about this on our portal.

Important! The disease is personalized, one clinical case does not resemble the other, the progress of the current always has different dynamics and depends on many diverse circumstances.

muscle twitching

The first (not always in order of occurrence) and one of the most common is a symptom of muscle twitching. It is called fasciculation and takes the following forms.

Under the skin, muscle tissue begins to contract. Twitching, trembling sensations are annoying to patients, but in fact nothing can be done about them. Muscle pulsations can occur, as always at the same point, or “wander” through the body, spreading over large areas.

Advice. There are two options for the development of events: either the fasciculations will go away on their own after some time (but then they may reappear), or they will intensify so much that you have to go to the doctor for medical treatment.

Muscle weakness

As soon as the flow of signals from motor neurons from the brain to the muscles begins to dry up (quantitatively decreases), they are not used to the full extent, and because of this they become weak, losing in mass. Muscle weakness can lead to imbalance and an increased risk of falling while walking.

Advice. Muscles, when their mass begins to decrease, will not be able to “pump up” again using exercises. But you need to do gymnastics, which includes balance exercises, as well as adjust the diet to slow down the thinning of muscle tissue.

It also stems from a decrease in the degree of use of muscles, which become less flexible, as if “woody”. This makes walking and standing difficult, causing frequent falls.

Advice. It is necessary to visit a physiotherapist to select a gymnastics program in order to increase the flexibility of the joints and their motor amplitude. With a nutritionist, it is worth adjusting the diet in order to maintain body weight and muscles.

Muscle cramps

Spasms and cramps of muscle tissue begin most often at night, but may later form in daytime, increase and intensify. They result from the cessation of signal transmission from the neuron to the muscle node. The muscle cannot recognize the signal and “tenses up”, which causes a spasm.

Convulsions are dangerous due to suddenness, strong unpleasant and pain symptoms and, ultimately, impaired motor skills.

Advice. To neutralize or weaken the symptom, you need to change your sitting / lying position more often during rest. The problem can be partially solved by regularly performing special muscle-relaxing exercises. And with strong and prolonged spasms, the doctor may prescribe an anticonvulsant drug.

Fatigue

It's not about the fatigue that comes after a whole day of work in the country. Fatigue that comes unexpectedly for no good reason is associated with a decrease in physical functionality in the muscle tissue. To maintain it in an active state (tone) requires more and more energy. It can also be breathing difficulties, shortness of breath, dehydration, or reduced food intake (malnutrition or malnutrition).

Advice. For an even distribution of forces, it is necessary to draw up a work plan for the day. Any physical activity interspersed with rest. Consult with a nutritionist and physiotherapist. Perhaps increase the amount of food consumed or increase its calorie content.

Pain syndrome

Pain does not follow directly from the diagnosis of amyotrophic lateral sclerosis. The disease does not cause any pain or even discomfort. But pain syndrome can be expressed, and quite strongly, due to a number of reasons:

• muscle spasm;
• squeezing the skin;
• muscle tension;
• joint closure.

It is important to identify the cause pain to eliminate them.

Advice. Recommendations for the best positions bodies to be occupied by the patient, and exercises to relieve local pressure may be given by the doctor. Also possible drug therapy, with prescribing both antispasmodics and anabolics.

Difficulty swallowing

When the muscles of the body begin to be affected, the turn soon comes to the facial muscles. With muscular atrophy of the larynx, difficulty in swallowing begins. This medical phenomenon has a name - dysphagia. Of course, the process makes it difficult to take food and liquid products, so the patient begins to eat less and receives much less nutrients, which, in turn, leads to a decrease in muscle mass and even more difficulty in swallowing.

Advice. It is necessary to contact two specialists: a speech therapist and a nutritionist. The first, having assessed the degree of violations, will recommend exercises to alleviate the problem, the second will form a diet in such a way that the maximum amount of energy carriers enters the patient's body with a minimum amount of food. At a later stage, it may be necessary to replace the traditional way of eating with an alternative one.

Salivation

If swallowing dysfunction begins, saliva accumulates in the mouth, which cannot be swallowed. The same thing happens with phlegm. This leads to involuntary uncontrolled salivation, which cannot but cause discomfort. If the patient is dehydrated, the saliva may be viscous. Dysfunction of salivation causes candidiasis of the oral mucosa and dryness.