What are the 7 Stages of ALS?

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Lou Gehrig's Disease, widely known as amyotrophic lateral sclerosis (ALS), is a progressive nervous system ailment that affects the brain and spinal cord nerve cells and results in a total or partial loss of muscle control. 

ALS often starts with muscle twitching, incoherent speech, or weakness in the hands and other body parts, which may lead to complete loss of muscle control required to move, speak, eat, or even breathe. The condition is very rare, and unfortunately, there is no cure for ALS. 

Risk Factors for ALS 

ALS can affect anyone. However, there are common risk factors that make certain individuals more prone to ALS than others which may include: 

  • Advanced Age: Although the condition can strike at any age, ALS symptoms often surface in the latter part of life, i.e., between the ages of 55 to 75. 
  • Gender: Men are more prone to get diagnosed with ALS than women. 

Is ALS genetic? 

A person may inherit the disease from a parent. Subsequently, in the cases of people with familial ALS, the children have a 50-50 chance of developing the disease.  

Interestingly, some studies have found many similarities in the genetic variations of people with familial ALS and non-inherited ALS. Experts believe that these genetic variations may increase the chances of individuals developing ALS. 

Symptoms of ALS 

Lou Gehrig's disease begins with muscle weakness that spreads and worsens over time. ALS signs and symptoms vary from person to person, depending on the neurons affected. Some signs and symptoms may include: 

Unlike other neurological disorders such as Alzheimer's, a person diagnosed with ALS does not lose their mental and reasoning abilities. Patients with ALS are aware of their loss of muscular capacity. 


7 Stages of ALS 

In ALS patients, the motor neurons slowly progress through the seven stages, leading to diminished abilities of a person to speak, write, walk, or breathe, resulting in a shortened life expectancy. 

1. The Early Stage 

Older adults affected by ALS start experiencing weakened grip, poor balance, and trouble talking and communicating. These symptoms make it difficult for them to manage their day-to-day chores, such as bathing and clothing, without assistance.  

If the symptoms primarily affect the arms or legs, the condition is known as limb onset ALS, whereas when the speech is influenced, the condition is known as bulbar onset ALS. 

2. The Diagnosis Stage 

The second stage is also known as the diagnosis phase. During this phase, the signs are visible, and the muscle weakness also spreads to other parts of the body. 

Typically, the doctor looks into the individual's test results and medical history to get a clearer picture of the situation. Some studies have also emphasized the troubles associated with accurately diagnosing ALS. It is because ALS symptoms can mimic other neurological disorders.  

Doctors usually perform the following tests to confirm ALS disease: 

  • MRI Scans 
  • Urine tests 
  • Blood tests 
  • Thyroid and parathyroid hormone level tests 
  • Electromyography tests 
  • Nerve biopsies 
  • Neurological check-ups 
  • Muscle biopsies 

3. The Middle Stage: Second Region 

The muscles in the lungs responsible for carrying out respiratory functions are most likely to become compromised in these stages. While some muscles grow paralyzed, some unused muscles become shortened forever. This medical condition, called contracture, prevents joints such as elbows from straightening completely. 

As the stages progress, muscle weakness starts to cause graver difficulties in eating and swallowing, increasing the risk of choking. Some Bulbar ALS patients in this stage may also experience PBA pseudobulbar effect. 

4. The Middle Stage: Third Region 

As the condition advances, patients with ALS begin to experience limited mobility functions. They may require a caregiver's assistance for personal hygiene tasks such as bathing and toileting. ALS patients may also have to deal with chronic headaches, fatigue, and pneumonia at this stage. 

5. The Mandatory Gastrostomy Stage 

Patients in the fifth stage of ALS require G-tube procedures for nutritional support and enhanced survival chances. Individuals with dysphagia may deal with weight loss, swallowing, and breathing difficulties. 

6. The Late Stage 

The sixth stage is largely called the end or late stage. In this stage, a ventilator is introduced for the patient to keep breathing since most voluntary muscles are on the verge of dying. Muscle groups involved in breathing become more fragile, and the body is declared unfit to draw sufficient air for breathing. 

7. The Death Stage 

The final phase of ALS disease is death. A patient eventually passes because of a lack of air and collapsed lungs. Respiratory failure, pneumonia, and cardiovascular problems become significant reasons for worsening the situation of people diagnosed with ALS.   

Treatment for ALS 

Sadly, ALS disease does not have a definite treatment or cure. However, different treatments are available to manage ALS symptoms and provide substantial support and care to the patient. Treating the symptoms of ALS as they occur can better the chances of survival.  

This includes incorporating an enteral tube feeding procedure for nutritional reasons, ventilators for breathing support, using dysphagia cups and utensils for those with a weaker grip, and pain relief for debilitating arm and leg muscles. 

Doctors also offer prescription drugs to reduce the signs and symptoms of ALS and control muscle pain and cramping. While a few medicines are used to treat the progressions of ALS symptoms, their effectiveness is still unclear.  

If you have sufficient reasons to believe you or your loved one is experiencing any indications of any of the seven stages of ALS, please make sure to consult your doctor as soon as possible. 


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