About ALS

In its early stages, ALS can mimic other neurological conditions. A neurologist who specializes in ALS can provide an accurate, timely diagnosis.

First, the neurologist will discuss your medical history, including your family and personal health history. Then we will conduct a physical and neurological exam, an MRI and a blood, urine and thyroid hormone test to rule out other underlying conditions. 

To confirm an ALS diagnosis, we will conduct two neuromuscular tests:

• An EMG will evaluate the electrical activity of your muscles at rest and in contraction. The EMG can detect involuntary movements, spontaneous twitches and reduction of voluntary motor function. It can also show us where healthy neurons exist to potentially reinnervate damaged neurons. 
• A nerve conduction velocity study will measure how well your nerves send impulses to other areas of the body, which can show us areas of nerve damage. Slower transmission speeds can indicate ALS or another neurological condition.

Combining these various data points requires investigative and neurological expertise. Team Hope includes experts in both — we are here with swift, compassionate support from diagnosis through symptom management.

Though there is not yet a cure for ALS, there are comprehensive therapies to manage symptoms and improve your quality of life. ALS is a full-body condition, and Houston Methodist offers integrative treatment plans that cover physical, neurological and emotional health needs.

Medication 
Riluzole can help slow the progression of ALS. In some patients, it can reduce the levels of toxic glutamate in the brain. Anti-inflammatory medications can relieve joint discomfort and strain caused by muscle weakness. ALS can cause emotional outbursts, such as crying or laughing — medications are available to control these symptoms.

Exercise and Behavioral Modifications 
Team Hope’s physical, occupational and speech therapists specialize in neuromuscular disease management. We will recommend an ALS therapy plan tailored to your symptoms and abilities. Your care plan may include:

• Aquatic exercises
• Breathing exercises
• Frequently changing position to avoid joint and tissue strain
• Hand and limb strengthening movements
• Riding a stationary bike
• Speech-language techniques for swallowing
• Stretching 
• Walking on even surfaces

To avoid injury, weightlifting and resistance training are not advised. Many patients with ALS require communication assistance. Items such as tablets, laptops and erasable boards can help you express yourself more clearly.

Small daily lifestyle changes can dramatically improve independence and emotional well-being. For example, wearing clothing with Velcro, button hooks and zipper-pull fasteners can reduce frustration surrounding getting dressed. Using mobility devices such as a cane, walker or wheelchair can help eliminate falls. Wearing adaptive devices, such as ankle- and foot-stabilizing orthotics, also can minimize falls and maximize endurance.

Respiratory Support
ALS can cause issues with breathing and swallowing. Our ALS experts offer customized care, including:

• Treatment of respiratory infections
• Supplemental oxygen for low blood oxygen levels 
• Aspiration risk management in patients with swallowing difficulties
• Medication to help decrease excessive saliva or phlegm 
• Nutrition guidance and support
• Vitamin supplementation (such as E, C and beta carotene)

Over time, your symptoms and support requirements will change. Working closely with Team Hope offers you and your family the best chance to notice and capitalize on therapy modification opportunities as they arise.