condition that affect both upper motor neuron and lower motor neuron

1. AMYOTRPHIC LATERAL
SCLEROSIS

2.  Names index numbers
 ABOTSI JOSEPH K. UHAS20178634
 BRAYIE CECELIA UHAS20173327
 ADU-DICKSON JULIET UHAS20178114
 STEPHEN ANANE UHAS20177601

3. OBJECTIVES
 INTRODUCTION
 BACKROUND AND HISTORY
 PATHOPHYSIOLOGY/DISEASE MECHANISM
 CLINICAL SIGNS AND SYMPTOMS
 DIAGNOSIS AND TECHNOLOGY
 TREATMENT APPROACHES

4. Introduction
 What is amyotrophic lateral sclerosis?
"a" for without
"myo" for muscle
"trophic" for nourishment
"lateral" for side (of the spinal cord)
"sclerosis" for hardening or scarring
 It’s a fatal disease of nervous system, characterized by
progressive muscle weakness resulting in paralysis.
 MOST LIFE PATTERN OF THIS PATIENT IS BETWEEEN 2-5 YEARS

5. Definition

Amyotrophic Lateral Sclerosis Pathology
◆ Degeneration and death of motor nerves
1. Upper Motor Neuron
– within brain/spinal cord
2. Lower Motor Neurons
– leaves brain (stem)/spinal cord
◆ Relatively spared
• Eye movements and bowel/bladder function

6. Background and history
 ALS also known as Lou Gehrig’s Disease or Motor Neuron
Disease (MND).
 ALS was first described in 1869 by Jean-Martin Charcot, a
French neurologist.
 And was brought to national attention once baseball
legend, Lou Gehrig was diagnosed with the disease in
1939

8. Cause and disease mechanism
 :
•Genetic Factor.
-- 20% are linked to a mutation in the SOD1 gene
-- Only a small amount is linked with mutant gene

•Glutamate:
when found in excess it builds up and causes an overflow of calcium into
motor neurons. This eventually leads to destruction of nerve
cells.
 •environmental factors :such as heavy metal exposure leads to damage nerve.
 •Viral infections: are yet another factor that may play a role in
the development of ALS.
 •Free Radical

10. Amyotrophic Lateral Sclerosis
Clinical Signs and Symptoms
◆ Weakness
◆ Hyporeflexia
◆ Pain and cramps
◆ Fasciculations
◆ Wasting
◆ Spasticity
◆ Hyperreflexia
◆ Babinski’s sign
◆ Emotional Lability

11. Clinical signs and symptoms
 Dysphagia:
 Weakness in Muscles:
 Slurred Speech
 Losing Control over Laughing and Crying
 Muscle Cramps
 Loss of Balance
 Overall Weakness and Fatigue
 Breathing difficulties

12. Bulbar Als Onset
•Condition where the disorder strikes the tongue rather than limbs
•Pons and medulla area of brain stem was known the or bulbar area of the brain
•The nerves on the facial region that are connected with the bulb region of the brain
controls Throat, jaw, tongue and face
Q) What are Bulbar ALS problems?
1. Slurred speech
2. difficulty in swallowing and chewing food etc

13. Diagnosis and technology
 Normally in the diagnosis of this condition three main studies are being considered
 1. Nerve conduction studies
• assess for demyelinating vs. axonal involvement
2. Electromyography
• confirm ALS
• myopathy
3. MRI cervical spine
• Cervical Spondylosis with cord compression
• Herniated disc
 Differential diagnosis
I. Dementia - < 5 %
◆ Sensory loss – atypical
◆ 25% complain of paresthesias
◆ Oculomotor dysfunction
◆ Bowel or bladder dysfunction

14. PHYSIOTHERAPY INTERVENTION
 Treatment is mostly considered from the MDT approach.
 Physical therapy that is tailored to the individual’s needs and goals and focused on
addressing symptoms and maximizing function and participation enables people with
ALS to live their lives to the fullest and with quality.
TREATMENT GOALS
 Improving function and providing instruction on managing physical disabilities.
 Recommending appropriate exercises to maintain flexibility, while preventing and
reducing physical pain.
 Providing instruction regarding the use of assistive devices, braces or other mobility
aids to maximize independence.

15. Treatment
1. Aerobic exercises in moderate
To help increase cardiovascular fitness ,heart rate etc
2. Stretching exercises(active and passive)
May help decrease the frequency or intensity of muscle cramping.
3. Range of motion exercises
This is to help reduce stiffness at the joint.
4. Strengthening exercises
5. Prescribing appropriate equipment, which helps with functional independence within
areas of occupation. Eg canes, wheelchairs, braces such as foot-ankle braces.

16. Reference
 Aebischer, P., & Kato, A. C. (2007). Playing defense against Lou Gehrig’s disease. Scientific
American, 297(5), 86-93. Retrieved from EBSCOhost.
American Occupational Therapy Association. (2008). Occupational therapy practice
framework: Domain and Process (2nd ed.). American Journal of Occupational Therapy, 62,
625-683
 Atchison, B. J., & Dirette, D. K. (2007). Conditions in Occupational Therapy (3rd ed., pp.
268-271). Baltimore, MD: Lippincott Williams & Wilkins.
 Bento-Abreu, A., Van Damme, P., Van Den Bosch, L., & Robberecht, W. (2010). The
neurobiology of amyotrophic lateral sclerosis. European Journal of Neuroscience, 31(12),
2247-2265. doi:10.1111/j.1460-9568.2010.07260.x
 Corcia, P., & Meininger, V. (2008). Management of amyotrophic lateral sclerosis. Drugs,
68(8), 1037-1048. Retrieved from EBSCOhost