Amyotrophic lateral sclerosis (ALS)

ALS is also known as

Lou Gehrig’s disease

Number of canadians living with ALS

3000

Amyotrophic lateral sclerosis (ALS) (2)

• Rare, progressive, neurological disorder characterized by loss of motor neurons in spinal cord and brain stem,

• and by weakness and atrophy of the muscles of the hands, the forearms, and legs, spreading to most of the body and face

ALS cause (2)

• Causative agent unknown

• Combination of genetic component and environmental factors

Average survival after diagnosis

• 2 - 6 years (textbook)

• 3 - 5 years (ashley) 

Signs and symptoms (13)

• Tripping

• Dropping things

• Slurred speech

• Difficulty swallowing

• Weight loss

• Decreased muscle tone

• Shortness of breath

• Increased or decreased reflexes

• Uncontrollable periods of laughing or crying

• Weakness

• Fatigue

• Muscle cramping or twitching

• Muscle stiffness or rigidity

Usually the first S+S of ALS (2)

Tripping and dropping things

ALS diagnosis (5)

• Clinical symptoms

• MRI and Electromyography

• Muscle and nerve function tests

  • to check conduction

• No labs definite

• Rule out other conditions

Management (12)

• Emotional support

• Supportive measures that address symptoms

• Prevent aspiration

• Prevent skin breakdown

• Nutrition

• Exercise to prevent spasticity

• Facilitating communication

• End of life decisions

• Assistive devices (wheel chairs, mechanical lifts, etc.)

• Pain management

• Mechanical Ventilation

• Medication

Supportive measures that address symptoms

• End of life decisions

  • “If you can’t breathe do you want mechanical breathing?”

Prevent aspiration (2)

• Raise HOB

• Thick fluids

Prevent skin breakdown (2)

Prevlon boots, frequent repositioning

Nutrition

Want to maintain weight

Medication (2)

• Riluzole (Rilutek)

• slows the progression of ALS. This medication works to decrease the amount of glutamate (an excitatory neurotransmitter) in the brain.

Nursing interventions (6)

• Facilitating communication

• Reducing risk for aspiration

• Early identification of respiratory insufficiency

• Decreasing pain

• Decreasing risk for fall-related injury

• Providing diversional activities

Facilitating communication (4)

Tools like:

• Eye gaze tracked by technology

• Finger on mousepad

• Printed pictures

• Be creative

Reducing risk for aspiration (2)

• Can aspirate on own secretions

• Suction at bedside

Early identification of respiratory insufficiency

Always monitoring respiratory status

Providing diversional activities (4)

audio books, music, radio, TV