Amyotrophic Lateral Sclerosis
At this time, Amyotrophic Lateral Sclerosis(ALS) is a very confusing and elusive disorder. While the clinical presentation and diagnosis of ALS dates back to the early 1900’s, with Charcot being the first to scientifically report and document his findings, there simply has not been definitive evidence since that time for the etiology for ALS. This fundamental problem has befuddled the most qualified researchers and its ensuing answer has eluded the most clever experiments for some 80 years.
This paper is being written to address some of the most plausible candidate causes which have come to the forefront of ALS research in the last few years. This paper will also try to tackle the formidable task of possibly uniting some of the findings and results of experiments from all over the world in the last 4 years. While an exact, definitive etiology, treatment, or answer is not possible at this time, there does seem to be a few underlying trends and findings that have reinforced their own importance. These are the findings that will be evaluated and will hopefully act as a genesis for, perhaps a premature, minimally complete conclusion of the available pool of knowledge that has been amassed on ALS. In addition to this, possible treatment, including pharmacological intervention, will be reviewed.
ALS is a disease of the skeletal muscular motor neurons throughout the nervous system that usually affects both upper and lower motor neurons. The progressive wasting and weakness of muscles that have lost their nerve supply is a characteristic sign of lower motor neuron damage; signs of spasticity and exaggerated reflexes are indications of damage to the upper motor neurons. Most of the time, ALS occurs sporadically (85%), with estimates ranging from 5-15% for the familial. The average age of onset is roughly 60. Even so, much more attention is giving to younger, healthy individuals who succumb to the disease.
The typical history usually involves early recognition of an onset of clumsiness in the hands and fingers, with a weakness in the legs soon to follow. There is also bulbar involvement that usually manifests in problems with speech and swallowing. This bulbar involvement is interesting in that it may be cytologically distinct from the corticospinal manifestation. The degenerative process itself is unforgivingly progressive, except for a few permanent plateaus, and for all reasonable assessments, will yield a fatal outcome. Even so, it should be noted that patients most often do not die from ALS, but from secondary causes such as infection and pneumonia.
When considering ALS, the relevant question is not what has been proposed as the causative agent, but what has not been proposed. Over the years, there has been a myriad of theories concerning the etiology of ALS, some with a valid premise and decent evidence, and others being way off the mark. Some of the theories that have...