Monday, 21 January 2013

ALS and MS

#MSBlog: What can ALS or Lou Gerhig's disease teach us about MS? A lot!

Trojsi F et al. Amyotrophic lateral sclerosis and multiple sclerosis overlap: a case report.Case Report Med. 2012;2012:324685. doi: 10.1155/2012/324685.

The concurrence of amyotrophic lateral sclerosis (ALS) and MS is extremely rare.  

ALS is a  neurodegenerative disease referred to as motor neuron disease. In the US it is also referred to as Lou Gehrig's disease, after the famous base ball player who died of the disease. 

Case report: This is a report of a case of a 33-year-old woman with a past history of paresthesias in the right hand, who developed progressive quadriparesis (weakness in all 4 limbs) with muscular atrophy of limbs and, finally, bulbar signs (face, tongue and throat muscles) and dyspnea (shortness of breath). Clinical and neurophysiologic investigations revealed upper and lower motor neuron signs in the bulbar region and extremities, suggesting the diagnosis of ALS. Moreover, magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis demonstrated 3 periventricular and juxtacortical lesions, hyperintense in T2 and FLAIR sequences, and oligoclonal bands, consistent with diagnosis of primary progressive MS (PPMS). 

Conclusion: This unusual overlap of ALS and MS leads to the discussion of a hypothetical common pathological process of immunological dysfunction in these two disorders, although the role of immune response in ALS remains ambivalent and unclear. 

Lou Gehrig

"The occurrence of MS and ALS in the same person is very rare and may happen by chance. However, the mechanisms underlying the progressive loss of nerve cells in both disorders may have common mechanisms and therefore one condition may predispose to the other. In addition, neurodegenerative drugs that are being developed for ALS may work in MS and vice versa. Therefore most  scientists and clinicians working in MS have more than a passing interest in ALS. For example, we are actively investigating the utility of neurofilaments as a biomarker in ALS and MS."

Please see other previous posts on ALS:
19 Jun 2012
Research Sclersosis MS and ALS are not associated. Epub: Boström et al. Mortality Statistics for Multiple Sclerosis and Amyotrophic Lateral Sclerosis in Sweden. Neuroepidemiology. 2012 Jun 5;38(4):245-249. Background: ...
15 May 2012
METHODS: 112 patients with sporadic ALS were followed up until endpoint (death or tracheostomy). Multivariate analyses were performed using the Cox proportional hazard model. Threshold tracking was used to measure ...

1 comment:

  1. I bet giving someone a diagnosis of ALS must be the hardest thing for a neurologist to do, only because it's such a horrible way to die.

    David Niven died from ALS. The recent documentary called JASON BECKER: STILL ALIVE. charts the story of an 19-year-old guitarist and his ALS journey. It's the worst way to go out.

    PPMS and ALS seem very similar. PPMS is the one type of MS no one wants to get because it reduces the sufferer to rubble.

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