· Lou Gehrig was known as professional baseball's "Ironman"

· At the peak of his career, he was diagnosed as having ALS

· Died 2 years later, at age 39

· Rapidly progressive, neuromuscular disease

· Attacks the motor neurons transmit electrical impulses from the brain to muscles

· Muscles fail to receive messages = lose strength, atrophy and die

· Average life expectancy after diagnosis: 3 to 5 years

· C9ORF72

o This gene, discovered in 2011, is the most common genetic cause of ALS (position of an “open reading frame” on chromosome 9)

o Mutations in this gene account for between 25% and 40% of all familial ALS cases gene mutation and act in a dominant manner

o How this gene causes ALS is unknown

· Early signs/symptoms

• Difficulty walking, tripping or difficulty doing your normal daily activities
• Weakness in your leg, feet or ankles
• Hand weakness or clumsiness
• Slurring of speech or trouble swallowing
• Muscle cramps and twitching in your arms, shoulders and tongue
• Difficulty holding your head up or keeping a good posture
• Disease begins in your hands, feet or limbs, and then spread
• Muscles become progressively weaker
• Affects chewing, swallowing, speaking and breathing
• Usually doesn’t affect bowel or bladder control, senses or thinking ability

· difficult to diagnose early because it may appear similar to other neurological diseases

· Tests to rule out other conditions:

o Electromyogram (EMG)

§ Inserts a needle electrode through your skin into various muscles

§ Evaluates the electrical activity of your muscles when they contract and rest

• Nerve conduction study
• This study measures your nerves' ability to send impulses to muscles in different areas of your body
• Magnetic resonance imaging (MRI)
• produce brain and spine image
• Blood and urine tests
• Analyzing samples of your blood and urine
• Spinal tap (lumbar puncture)
• Remove a sample spinal fluid for analysis
• Inserts a small needle between two vertebrae in your lower back and removes a small amount of cerebrospinal fluid
• Muscle biopsy
• Portion of your muscle is removed and analyzed

· ALS cannot be reversed

· Treatments: slow down progress of symptoms and prevent complications

• Riuzole (rilutek) is the only medication approved by the Food and Drug Administration for ALS
  

• Slows down the progression of symptoms and disease
  

· Breathing care

· Physical therapy

· Occupational therapy

· Speech therapy

• Heredity
• Age
• Sex/Gender

· Environmental factors

• Smoking
• Lead exposure