ALS & Motor Neuron Diseases
Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurodegenerative disorder that affects nerve cells responsible for voluntary muscle movement. Over time, it leads to muscle weakness, difficulty speaking or swallowing, and breathing challenges. While there is no cure, early diagnosis, multidisciplinary care, and emerging therapies can slow disease progression and preserve independence.
At The Medical Group of New Jersey, our ALS care team provides compassionate, comprehensive management, including medication, respiratory support, physical therapy, and assistive technologies, to help patients live with dignity and quality of life.
Symptom Onset & Initial Evaluation
Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurological disorder that affects the motor neurons responsible for controlling voluntary muscle movement.
Early symptoms may include:
- Gradual muscle weakness in the hands, arms, legs, or face
- Muscle cramps or twitching (fasciculations)
- Slurred speech or difficulty swallowing
- Fatigue, loss of coordination, or frequent tripping
Because ALS symptoms can resemble other neuromuscular diseases, early evaluation by a neurologist specializing in motor neuron disorders is critical for accurate diagnosis.
At your initial visit, your provider may perform:
- A comprehensive neurological exam to evaluate strength, reflexes, and muscle tone
- Electromyography (EMG) and nerve conduction studies (NCS) to assess nerve function
- MRI of the brain and spine to rule out structural causes
- Bloodwork and genetic testing to identify hereditary forms or related conditions
Diagnosis & Subtype Classification
ALS is primarily a clinical diagnosis, supported by EMG evidence showing loss of both upper and lower motor neurons.
Common classifications include:
- Sporadic ALS: The most common form, occurring without family history.
- Familial ALS: Inherited, accounting for about 5–10% of cases, often linked to genetic mutations such as SOD1 or C9orf72.
- Bulbar-Onset ALS: Begins with speech and swallowing difficulty.
- Limb-Onset ALS: Starts with weakness in the arms or legs.
Your neurologist will use the revised El Escorial criteria and comprehensive testing to confirm the diagnosis and develop an individualized treatment plan.
Treatment & Ongoing Management
Although there is currently no cure for ALS, new therapies and coordinated multidisciplinary care can slow progression, reduce symptoms, and preserve quality of life.
Medications:
- Riluzole: Extends survival by reducing motor neuron damage.
- Edaravone (Radicava®): Protects against oxidative stress and may slow disease progression.
- Tofersen: A targeted genetic therapy approved for SOD1-related ALS.
- Symptom management: Medications for spasticity, saliva control, pain, or emotional changes.
Respiratory Support:
- Noninvasive ventilation (BiPAP) improves breathing and prolongs life expectancy.
- Regular pulmonary monitoring ensures early intervention as respiratory function declines.
Nutritional Support:
- Work with a dietitian to maintain caloric intake and muscle strength.
- Feeding tube (PEG) placement may be recommended if swallowing becomes difficult.
Rehabilitation:
- Physical and occupational therapy to maintain mobility and reduce stiffness.
- Speech therapy to assist with communication and swallowing safety.
- Assistive devices such as braces, wheelchairs, and voice-generating technology.
Multidisciplinary & Supportive Care
The Medical Group of New Jersey follows a comprehensive, team-based approach to ALS management. Each patient’s care team may include:
- Neurologists, pulmonologists, and physiatrists
- Speech and respiratory therapists
- Physical and occupational therapists
- Dietitians, social workers, and palliative care specialists
This integrated model helps patients and families navigate physical, emotional, and logistical challenges with continuous guidance and compassionate support.
Prognosis & Long-Term Outlook
The progression of ALS varies widely between patients. With early diagnosis, proactive care, and new FDA-approved therapies, many individuals experience slower functional decline and improved comfort.
Our specialists at The Medical Group of New Jersey stay current with emerging research and clinical trials to connect patients with the latest treatment opportunities and hope for the future.