Amyotrophic Lateral Sclerosis (ALS)
Nursing Care Plan & Management
Definition
● Amyotrophic lateral sclerosis (ALS) is a disease of unknown cause in which there
is a loss of motor neurons (nerve cells controlling muscles) in the anterior horns of
the spinal cord and the motor nuclei of the lower brain stem.
● It is often referred to as Lou Gehrig’s disease.
Risk Factors
● Autoimmune
● Free radical damage
● Oxidative stress
● Cigarette smoking
,Pathophysiology
● As motor neuron cells die, the muscle fibers that they supply undergo atrophic
changes. Neuronal degeneration may occur in both the upper and lower motor
neuron systems.
● The leading theory held by researchers is that over excitation of nerve cells by the
neurotransmitter glutamate leads to cell injury and neuronal degeneration.
Assessment/Clinical Manifestations/Signs and Symptoms
The signs and symptoms presented depend on the location of the affected neuron. Generally,
the following presentations are evident:
● Fatigue
● Progressive muscle weakness
● Cramps
● Twitching
● Incoordination
Anterior horns
● Progressive weakness
● Muscle atrophy (arms, trunk, legs)
● Spasticity
● Brisk or overactive muscle reflexes
, Cranial nerves
● Muscle weakness
● Difficulty talking
● Difficulty swallowing
● Difficulty breathing
● Soft palate and upper esophageal weakness
● Weakness on the posterior tongue
Bulbar muscles
● Progressive difficulty in speaking
● Difficulty in swallowing
● Articulation and speech effects
● Compromised respiratory function
Diagnostic Tests
The following tests and assessment tools are used to verify the presence of Amyotrophic
Lateral Sclerosis:
● EMG studies of affected muscles indicate reduction in the number of functioning
motor units
● MRI may show high signal intensity in the corticospinal tracts
Medical Management
No specific therapy exists for ALS. The main focus of medical and nursing management is on
interventions to maintain or improve function, well-being and quality of life.
Nursing Care Plan & Management
Definition
● Amyotrophic lateral sclerosis (ALS) is a disease of unknown cause in which there
is a loss of motor neurons (nerve cells controlling muscles) in the anterior horns of
the spinal cord and the motor nuclei of the lower brain stem.
● It is often referred to as Lou Gehrig’s disease.
Risk Factors
● Autoimmune
● Free radical damage
● Oxidative stress
● Cigarette smoking
,Pathophysiology
● As motor neuron cells die, the muscle fibers that they supply undergo atrophic
changes. Neuronal degeneration may occur in both the upper and lower motor
neuron systems.
● The leading theory held by researchers is that over excitation of nerve cells by the
neurotransmitter glutamate leads to cell injury and neuronal degeneration.
Assessment/Clinical Manifestations/Signs and Symptoms
The signs and symptoms presented depend on the location of the affected neuron. Generally,
the following presentations are evident:
● Fatigue
● Progressive muscle weakness
● Cramps
● Twitching
● Incoordination
Anterior horns
● Progressive weakness
● Muscle atrophy (arms, trunk, legs)
● Spasticity
● Brisk or overactive muscle reflexes
, Cranial nerves
● Muscle weakness
● Difficulty talking
● Difficulty swallowing
● Difficulty breathing
● Soft palate and upper esophageal weakness
● Weakness on the posterior tongue
Bulbar muscles
● Progressive difficulty in speaking
● Difficulty in swallowing
● Articulation and speech effects
● Compromised respiratory function
Diagnostic Tests
The following tests and assessment tools are used to verify the presence of Amyotrophic
Lateral Sclerosis:
● EMG studies of affected muscles indicate reduction in the number of functioning
motor units
● MRI may show high signal intensity in the corticospinal tracts
Medical Management
No specific therapy exists for ALS. The main focus of medical and nursing management is on
interventions to maintain or improve function, well-being and quality of life.
