ALS Case Study Paper

ALS Case Study Paper

Amyotrophic lateral sclerosis it’s a neural disease that affects the spinal cord and the brain. It is caused by the death of neutrons, which command the voluntary muscles in a body. The mechanism of this disease involves the death of the upper and lower neurons (2010). The cause of the ALS is unknown, and patients diagnosed with the disorder have a life expectancy of 2 to 4 years, the highest being up to 10 years, depending on the increasing speed of the disease. ALS can affect any person of any age, but it’s mostly manifest itself between the age of 50 to 60 years. The spinal beginning of ALS is more common in men than in women. A pathological mark of the ALS would be the buildup of the aggressive and abnormal proteins in the cytoplasm of the nerve cells. This buildup usually occurs in a single spinal cord region and then spreads to the rest regions.  Another cause of the death of neurons is a decreased balance of a chemical called the glutamate that transports the excitotoxicity produced by the extreme intercellular calcium. The motor cells have a low tolerance of the excess calcium and therefore cause death to them.

In T.H., the most common characteristics that are seen in his symptoms include the twitching of muscles, the stiffening of the flesh, also the excessive emotional disorder like involuntary laughing, unclear speech, and the presence of excessive saliva that causes him to drool. T.H.’s medical history indicates that the damage of both the lower motor neurons and the upper motor neutrons begin dying during the eight months. This means that the anterior or the front part of the spinal cord has started to degenerate, causing the increased muscle weakness, which caused him to trip on things and eventually, the twitching of the muscles. In the future, T.H. may experience progressed symptoms like difficulty in swallowing. Also, there can be minor difficulties in thinking, and he might also suffer from pain.  The last sign would be the failure of the respiratory muscles where the patient experiences problems in inhaling and exhaling and eventually stops breathing, causing death.

The diagnosis comes from every person’s signs and symptoms. In T.H. case, a series of testing is done to rule out other potential causes of the symptoms. There are two known testing methods used to diagnose a patient. They are the EL Escorial process that includes a test done to the four parts of the spinal cord. These are lumbar, thoracic, bulbar, and cervical. When three of these levels have signs of degenerating of the motor neurons, it’s a definite presence of ALS. If two or one of the parts has the signs, the disease is probable. The other method is the Awaji technique, which includes a series of laboratory tests that show the three categories of the definite, probably, and possibly the presence of ALS. In the two methods, the Awaji criteria is most preferred since it makes better sense compared to the EL Escorial, which was initially designed for clinical trials to study patients.

Every purpose of treatment for the ALS is to improve the symptoms (2017).  Three methods can be used for the process of the treatment include the non- invasive ventilation technique. This method increases both the quality and the life expectancy length of a patient. Another way is mechanical ventilation, which prolongs the survival rate of the patient, but eventually, it cannot prevent the progression of the disease. Finally, there is a treatment called Viluzole, which also does not stop the disease, but it improves and extends the patient’s life with two to three months.  When the patient has difficulty swallowing, the use of a feeding tube may help to get the required nutrients to the body.

To diagnose ALS, the patient undergoes a series of tests. This is because in the early stages of the disease diagnosis, there can be other disorders that usually mimic the signs and symptoms of the ALS. These tests are done to rule out the possibility of other neural diseases that are treatable. Some of these diseases are a tumor on the spinal cord, where magnetic resonance imaging(MRI) can be conducted to rule out the disease. Another test is performed on urine samples to cancel out a possibility of a condition called myopathy, which has symptoms like the ALS. Some infectious diseases have ALS characteristics. They include Lyme disease, syphilis, and the human immunodeficiency virus(HIV).

As a person diagnosed with ALS, T.H. may experience certain complications that are related to the disease. These complications may include cases of pneumonia, choking on food, drinks or saliva, malnutrition due to the difficulties in swallowing food and bedsores, which can be brought about by muscle cramps. The greatest cause of death to the ALS patient is the failure of the respiratory system. Although there is no cure, the supportive care and treatment provided to the patient may develop a value of their life.