Amyotrophic lateral sclerosis: pathogenesis, differential diagnoses, and potential interventions.

BACKGROUND

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative motor neuron disease. The etiology is likely multifactorial, involving both genetic and environmental factors.

METHOD

Literature review.

FINDINGS

Motor neuron death is believed to arise from mutations in superoxide dismutase 1. Abnormal neurofilament metabolism, glutamate transporter dysfunction, and altered responses to growth factors may play a role. These discoveries have highlighted possible interventions, several of which have subsequently undergone human clinical trials. These include studies of antioxidants, antiglutamatergic agents, cyclooxygenase inhibitors, and various growth factors.

CONCLUSION

Findings are inconclusive, and further investigations are underway. At present, nonpharmacologic interventions such as nutritional support; physical, speech, and occupational therapy; and respiratory management offer the best means of improving quality of life for patients with ALS.