Amyotrophic Lateral Sclerosis (ALS) is a degenerative disease upper and lower motor neuron, which is growing rapidly which led to an almost total paralysis. The loss of motor neurons do not include cranial nerves III, IV, and VI. Thus, some facial movements, including blinks retained. The disease is usually fatal within 5 years to grow, although some people can live much longer. Motor neuron degeneration occurs without apparent inflammation. Although the myelin not the primary point of degeneration, loss of nerve axons, cause loss of myelin and scarring. The cause of ALS is not known although it is expected a viral infection, and metabolic disorders and trauma. In addition, there ALS is genetic that can affect the likelihood of suffering from ALS patients by 10%. Recent evidence suggests that the genetic relationships can occur in more cases. (Elizabeth, 2009)
Generally patients showed atrophy and weakness of the muscles of the upper limb is more often than lower extremities.
Cramps and fasciculations can precede motor symptoms more. Motor signs are usually asymmetrical.
There is no sensory symptoms and no involvement of the sphincter that causes pelvic and abdominal muscle weakness and decreased fluid intake.
Some patients may experience a frontal-type dementia.
Most patients showed symptoms of dysarthria and dysphagia (progressive bulbar palsy variants).
There are signs mixture bulbar palsy, and pseudo bulbar, such as atrophy, but the reflex of the jaw increases.
Patients at risk for infection due to aspiration and muscle weakness mechanism is disrupted.
4 Nursing Diagnosis for Amyotrophic Lateral Sclerosis (ALS)
- Ineffective breathing pattern related to respiratory muscle weakness.
- Risk for imbalance nutrition: less than body requirements related to dysphagia / swallowing difficulties, secondary to cranial nerve disorders.
- Impaired verbal communication related to dysarthria.
- Impaired physical mobility related to weakness and muscular damage secondary to neuromuscular damage.