ALS Diagnosis and Treatment

How Is ALS Diagnosed?

Diagnosing Amyotrophic Lateral Sclerosis (ALS) can be difficult because there is no single test or procedure to confirm the disease. Moreover, since many neurologic diseases cause similar symptoms, appropriate tests must be conducted to exclude the possibility of other conditions first.

Diagnosing ALS may involve:

  • Electrodiagnostic tests (EMG/NCS): Electomyography (EMG) and nerve conduction study (NCS) evaluates muscle and nerve functions. Specific abnormalities in the NCS and EMG may suggest, for example, that the individual has a form of peripheral neuropathy (damage to peripheral nerves) or myopathy (muscle disease) rather than ALS.
  • Magnetic resonance imaging (MRI): A noninvasive procedure that uses a magnetic field and radio waves to take detailed images of the brain and spinal cord.
  • Blood and urine studies
  • Muscle biopsy

How Is ALS Treated?

Although there is no known cure for ALS, treatment may help relieve symptoms and improve the quality of life. Treatments may include:

Medications

We at Michigan Medicine prescribe medications that are approved for ALS including Riluzole and Edaravone.

  • Riluzole: Clinical trials with ALS patients showed that Riluzole prolongs survival by several months, mainly in those with difficulty swallowing. The drug also extends the time before an individual needs ventilation support. 
  • Edaravone: The medicine works by relieving the effects of oxidative stress, which may be related to the death of motor neurons (nerve cells) in people with ALS. Keeping motor neurons healthy may help to preserve muscle function.
  • Relyvrio
  • Tofersen

Physicians can also prescribe medications to help reduce fatigue, ease muscle cramps, and reduce excess saliva and phlegm. Drugs also are available to help patients with pain, depression, sleep disturbances, and constipation.

Therapies

  • Physical and occupational therapy: Physical therapy and special equipment can enhance an individual’s independence and safety throughout the course of ALS. Gentle, low-impact aerobic exercise such as walking, swimming, and stationary bicycling can strengthen unaffected muscles, improve cardiovascular health, and help patients fight fatigue and depression.
  • Speech therapy: As ALS progresses, speech therapists can help people develop ways for responding to yes-or-no questions with their eyes or by other nonverbal means and can recommend aids such as speech synthesizers and computer-based communication systems. These methods and devices help people communicate when they can no longer speak or produce vocal sounds.
  • Breathing devices: When the muscles that assist in breathing weaken, use of nocturnal ventilatory assistance may be used to aid breathing during sleep. These devices may be used full-time as the disease reaches more advanced stage.
  • Feeding tube: When individuals can no longer get enough nourishment from eating, doctors may advise inserting a feeding tube into the stomach. The use of a feeding tube also reduces the risk of choking and pneumonia that can result from inhaling liquids into the lungs.

 

Researching the Future of ALS

Pranger ALS Clinic

Michigan Medicine offers cutting edge research and every patient that comes to our clinic can participate in some form of research. While treating persons with ALS or other motor neuron diseases is a large part of our clinic, we are also at the forefront of ALS research.

Using many approaches, including basic laboratory research, epidemiologic research, and clinical trials, the University of Michigan is making major contributions to our understanding of ALS and the discovery of new treatment options.

One major research focus is identifying why people living in Michigan seem to be at a higher risk of ALS compared to other states. Led by Dr. Stephen Goutman, we evaluate for environmental risk factors via a survey and house an ALS patient biorepository that provides samples of biofluids (such as blood) to ALS researchers.

Researchers under the direction of Dr. Eva Feldman use these biofluids to better understand changes in gene expression and the immune system. These biospecimens are used in the laboratory to understand ALS pathogenesis and create models to screen and identify new therapies.

Clinical Trials

  • We recently completed a safety study of stem cell therapy for the treatment of ALS led by Dr. Eva Feldman.
  • We are active with the Northeast ALS Consortium (NEALS) and have recently participated in studies of retigabine, mexiletine, and tirasemtiv. Our current trials can be found at ClinicalTrials.gov

Make an Appointment

To request an appointment or to get more information, please call 734-936-9006 and a team member will get back to you within two business days.


Online resources from the following organizations were cited for information on Amyotrophic lateral sclerosis (ALS)symptoms, diagnosis and treatment:  

  • National Institute of Neurological Disorders and Stroke
  • National ALS Registry