ALS is a rare and progressive neurological disease. This article describes the complications that arise over time in ALS patients, including breathing problems, eating problems, dementia, speech problems, and many others.
Amyotrophic lateral sclerosis (ALS) is a rare neurological disease that develops due to a loss of motor neurons, which are the nerve cells that are responsible for controlling voluntary muscle movement. ALS is a progressive disease, which means it gets worse over time. Generally, the disease progresses over a period of time of 3 to 5 years.
Because there is no cure for ALS, complications such as breathing problems, eating problems, dementia, speech problems, pressure ulcers, pseudobulbar, primary bulbar palsy, progressive muscle atrophy, and lateral sclerosis primary, often develop over time.
These are the following complications that can arise in patients with ALS:
1. Breathing (breathing) problems
The muscles involved in breathing eventually become paralyzed due to the loss of motor neurons. ALS patients have very common breathing problems, and respiratory failure is the leading cause of death in ALS patients.
For the treatment of respiratory complications, patients can often use breathing strategies. However, patients may eventually require respiratory devices, such as bi-level positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP) to help them breathe at night.
Also, because of the significant breathing problems faced by late-stage patients, many people choose to have a tracheostomy, which uses a machine known as a ventilator that automatically inflates and deflates the patient’s lungs.
2. Feeding problems
Like respiratory problems, ALS patients often experience eating problems due to their motor neurons losing the ability to control the muscles that are responsible for swallowing. This can lead to a number of problems including:
Pneumonia: As patients develop swallowing problems, they are more likely to develop pneumonia because food, saliva, and fluids (and the bacteria they carry) can go down the wrong pipe and enter the lungs.
Malnutrition: As swallowing is impaired and patients are no longer able to swallow properly, this causes many patients to eat less nutritious food, leading to malnutrition, dehydration, and often anorexia.
To address these feeding problems, many patients chose to use a feeding tube to reduce these risks. Additionally, supplementing with vitamins and other nutrients can help treat malnutrition.
ALS patients are known to be at increased risk of developing dementia and dementia-related diseases. These are the types of dementia that ALS patients can develop:
Frontotemporal dementia: a progressive brain disease that is associated with changes in behavior, personality, and language dysfunction due to loss of nerve cells.
Alzheimer’s Disease: The most common type of dementia, Alzheimer’s disease is a chronic neurological disease that is largely associated with short-term memory loss. There are medications that can help slow the progression of dementia disease, but there is no cure.
4. Speech problems
Like other complications, speech problems develop as a result of the loss of motor neurons that control the muscles responsible for speech. Most ALS patients will begin to suffer from mild problems, such as slurring of words. However, this will get worse over time. At first, many patients will work with a speech therapist to make their speech easier to understand.
The patient’s speech becomes more difficult to understand, it is likely that the patient needs communication technologies and assistive devices in order to understand him better. For example, there are computers and mobile phone applications that allow patients to type and the program will read it out loud. These apps will also have to select certain phrases so they don’t have to type everything.
Additionally, many advanced programs can communicate with the patient using brain-computer interfaces, allowing communication without having to write or speak. These programs allow the patient to control the computer through their brain waves. Therefore, these programs are good for patients suffering from paralysis.
5. Pressure sores
Studies have shown that ALS patients are at increased risk of developing pressure ulcers, which are ulcers on the skin and underlying tissue that develop due to the prolonged pressure of sitting or lying down. The risk is particularly high for women and younger patients.
6. Pseudobulbar affect
Many ALS patients will develop a complication known as the pseudobulbar characterized by sudden, uncontrolled laughter or crying. This can happen multiple times throughout the day and often does not match the severity of the situation.
7. Primary bulbar palsy
Some ALS patients will develop primary bulbar palsy caused primarily by loss of nerve cells that control the bulbar muscles (which are involved in controlling speech, swallowing, and chewing).
The first muscles affected are those that control speech and swallowing, causing problems swallowing and breathing early in the disease. Patients may also feel weak in the facial muscles and tongue. Patients with primary bulbar palsy have a worse outcome compared to other types of ALS patients.
8. Progressive muscular atrophy
Patients with ALS develop progressive muscle atrophy, characterized by muscle wasting and weakness. This complication does not affect speech and swallowing. Patients also do not experience spasticity. Patients with progressive muscular atrophy tend to have a slower course of the disease compared to others.
9. Primary lateral sclerosis
The ALS patient may develop primary lateral sclerosis, which is characterized mainly by spasticity without muscle atrophy. Patients with primary lateral sclerosis have a better outcome.