ALS, is a progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle control.

CAUSES - ALS affects the nerve cells that control voluntary muscle movements such as walking and talking (motor neurons). ALS causes the motor neurons to gradually deteriorate, and then die. Motor neurons extend from the brain to the spinal cord to muscles throughout the body. When motor neurons are damaged, they stop sending messages to the muscles, so the muscles can't function. ALS is inherited in 5% to 10% of people.

RISK FACTORS-

Heredity. - Five to 10 percent of the people with ALS inherited it (familial ALS). In most people with familial ALS, their children have a 50-50 chance of developing the disease.

Age   - ALS risk increases with age, and is most common between the ages of 40 and the mid-60s.

Sex - Before the age of 65, slightly more men than women develop ALS. This sex difference disappears after age 70.

Genetics -   Some studies examining the entire human genome found many similarities in the genetic variations of people with familial ALS and some people with no inherited ALS. These genetic variations might make people more susceptible to ALS.

Environmental factors, such as the following, might trigger ALS.

Smoking -  Smoking is the only likely environmental risk factor for ALS. The risk seems to be greatest for women, particularly after menopause.

Environmental toxin exposure -  Some evidence suggests that exposure to lead or other substances in the workplace or at home might be linked to ALS. Much study has been done, but no single agent or chemical has been consistently associated with ALS.

CLINICAL FEATURES:

• Difficulty walking or doing normal daily activities
• Tripping and falling
• Weakness in your legs, feet or ankles
• Hand weakness or clumsiness
• Slurred speech or trouble swallowing
• Muscle cramps and twitching in your arms, shoulders and tongue
• Inappropriate crying, laughing or yawning
• Cognitive and behavioral changes
• Diffuse weakness, wasting, muscle “flickering”
• May be cramps &vague sensory complaints
• Diffuse weakness, wasting & fasciculation's of at least 3 limbs or 2 limbs &bulbar muscles
• Mixed upper & lower motor neuron deficit
• Babinski signs
• Bulbar palsy

COMPLICATION

Dysphagiais common

Dysarthiaor dysphonia

Aspiration pneumonia

Respiratory insufficiency

HOMOEOPATHIC MANAGEMENT:

Alumina: Vertigo also that comes on when closing the eyes, as is found in spinal affections, in sclerosis of posterior lateral columns. Alum. has produced affections analogous to locomotor ataxia. It produces numbness of the soles of the feet, the fulgurating pains, the vertigo when closing the eyes, and produces staggering and disturbances of co-ordination.

Argentum Nitricum : has been used with marked benefit in amyotrophic lateral sclerosis. Boericke especially mentioned in this there is spinal cord degeneration i.e. Lateral Sclerosis.

Crotalus Horridus : Painless paralysis of extremities, with numbness and great coldness of affected limb.Multiple sclerosis, lateral sclerosis, locomotor ataxia progressive muscular atrophy, tetanus ,Phatak says it has great effect in Sclerosis multiple, lateral. Progressive muscular atrophy.

Hypericum: Pain in nape of neck. PRESSURE OVER SACRUM. Spinal concussion. Coccyx injury from fall, with pain radiating up spine and down limbs. MOST IMPORTANT REMEDY FOR SPINAL INJURIES. Spinal Degeneration Lateral Sclerosis Feeling of weakness and trembling of all the limbs. Sensation of lameness of the left arm and right foot. Cannot walk, from affection of the spine.

Lathyrus sativus: pictures lateral sclerosis and spastic paraplegic conditions with excessively exaggerated reflexes. No pain, but motor paralysis of the lower extremities, absence of atrophy. Excessive rigidity of legs, spastic gait. Tremulous, tottering gait. Knees knock together when walking. Knee jerks exaggerated. Cannot extend or cross legs when sitting.

Plumbum Met: lead can cause a syndrome clinically indistinguishable from motor neuron disease, particularly one of its subtypes, amyotrophic lateral sclerosis (ALS). Lead in potency could probably increase the elimination of lead from the body and therefore might be useful in conditions where decalcification of bone leads to freeing of lead into the circulation. It might therefore be, at least, protective in these circumstances

Cuprum Met: It is useful in AMYOTROPHIC, LATERAL, SPINAL SCLEROSIS and PARALYSIS of the brain when there is vomiting and spasms with general coldness and blueness of the lips, dependent upon the retrocession of an acute eruption. Amyotrophic lateral spinal sclerosis; paralysis after chorea apoplexy or typhoid and typhus; paralysis of lower extremities after abscess of psoas muscles, motory paralysis with atrophy and contractions or choreic automatic movements, sensibility normal; congestion in chest, palpitation of heart, pulse slow, weak and small; eyes closed, when opening them, eyeballs move about, eyelids twitch; icy coldness of feet or burning in soles of feet; paralysis ascending from periphery to centre.

Nux Vomica: Amyotropic lateral sclerosis. Spinal irritation with sudden loss of power in legs. Lateral spinal sclerosis. Spinal anemia. Myelitis and early stages of locomotor ataxia.