​Amyotrophic Lateral Sclerosis (ALS)/Motor Neuron Disease (MND)​​​

​Amyotrophic lateral sclerosis (ALS) is a group of rare motor neuron diseases, where the nerves in the brain and the spine progressively lose function due to destruction of the nerve cells that control muscle movement and voluntary muscle actions. This condition causes muscle weakness and as the disease progresses, the nerves controlling breathing and other vital body functions are affected, leading to eventual respiratory failure in most cases.

The cause for ALS has not yet been deduce​​d. However, it is believed that it may be inherited or linked to certain environmental factors, including disorganized immune response, chemical imbalance and incorrect processing of proteins by nerve cells in the body.

The risk of ALS increases with age and it is slightly more common in men than women. ALS greatly reduces a person’s life expectancy.
Early symptoms of ALS include fatigue in the limbs, muscle cramps and twitches, and slurred speech. However, as the disease progresses, the following signs and symptoms may become evident:

  • Difficulty in doing everyday activities, including walking
  • Weakness in the feet, hands, legs and ankles and frequent tripping
  • Difficulty using the hands for simple tasks or clumsiness
  • Having trouble swallowing
  • Slurred speech
  • Difficulty holding the head up
  • Cramping and twitching in the arms and/or shoulders
Some people with ALS can also experience symptoms of impaired decision-making and memory, eventually leading to a form of dementia called frontotemporal dementia.

If you have been experiencing the early symptoms of ALS, including weakness of arms and/or legs, difficulty in walking, slurred speech, muscle cramps or stiffness, or issues with swallowing, seek expert advice with our doctors working with the Mind and Brain Service Line at The Aga Khan University Hospital.

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.
The symptoms of ALS are often confused with those of other neurological diseases. Therefore, to make an accurate diagnosis, your doctor may ask you to undergo the following tests:

  • Electromyogram (EMG): This is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (known as motor neurons). During this test, a thin disposable needle will be inserted into multiple muscles to record their electrical activity.
  • Nerve Conduction Studies (NCS): The test shows how well signals travel along a nerve which can help find the cause of abnormal nerve function. 
  • Magnetic Resonance Imaging (MRI): MRI or magnetic resonance imaging is a test that uses magnetic waves to take pictures of the brain and spinal cord. You will be asked to lie down  inside a special machine which will then take pictures to be saved and viewed on a computer. Sometimes a special dye is injected into the bloodstream to enable doctors to see more clearly against the contrast.
  • Blood and urine tests: Your doctor may also withdraw blood samples and ask you to give a urine sample to examine for conclusive evidence.
  • Muscle biopsy: The procedure includes removal of a sample of muscle tissue for testing. Muscle biopsy may also be carried out in order to rule out a muscle problem rather than ALS.
There is no cure for ALS. However, the medicinal attempts focus on:

  • minimizing and eventually alleviating the effects of the symptoms,
  • preventing the development of unnecessary complications and,
  • attempting to slow the rate at which the disease progresses.
Your doctor may prescribe you medicines to provide relief from the symptoms.

Along with medicines, your doctor will also ask you to undergo either one or multiple therapies, depending upon the severity of your condition.

  • Physical therapy: your physical therapist will address your mobility issues, and help you do light exercises to maintain muscle strength and motion. He/she may also provide you equipment to help with your movements.
  • Occupational therapy: The therapy can help you maintain your independence despite gradually losing control over your arms and legs. Your therapist will suggest assistive technologies and adaptive equipment to help you maintain your daily routine.
  • Breathing therapy: As the disease progresses, your respiratory muscles will get weaker. Your doctor will check your breathing regularly and provide you with devices to assist with breathing at night.
  • Speech therapy: If your speech becomes slurred, your doctor may ask you to undergo speech therapy. Using adaptive techniques, your therapist will help with your speech so that it can easily be understood. He/she will also explore with you other methods of communication including writing.
  • Nutritional support: Your multidisciplinary team will help identify foods that will be easy to swallow and also provide your body with the required nutrients. You may eventually need a feeding tube.
The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.​
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and/or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.
The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.