MOTOR NEURON DISEASE
Amyotrophic Lateral Sclerosis (ALS), also known as Motor Neurone Disease (MND), or Lou Gehrig's disease, is a group of signs and symptoms caused by the death of the nerves (motor nerves) that control the voluntary muscles of the body. Amyotrophic Lateral Sclerosis is characterised by muscle twitching (fasiculations), stiff muscles, and worsening weakness due to muscles decreasing in size because they can not be activated by the damaged motor nerves (disuse atrophy). This leads to difficulty speaking, swallowing, walking and eventually breathing.
Five to ten percent of cases are inherited from a person's parents. About half of these genetic cases are due to one of two specific genes.
Ninety to ninety five percent of cases are sporadic, caused by unique factors affecting that individual, usually environmental variables.
Nerves activating the muscles of the face, throat and mouth are affected first in 25% of cases. These motor nerves start in the medulla oblongata of the brain stem. It used to be called the ‘bulb’, so this presentation is called Bulbar onset Amyotrophic Lateral Sclerosis. The symptoms usually spread to include other muscles throughout the body. Occasionally symptoms remain confined to one area of the spine.
The death of the motor nerves, and the subsequent disuse atrophy of the muscles, leads to muscle weakness and muscle spasm. Individuals may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel function and the extra-ocular muscles (the muscles that move the eyes) are usually not affected until late in the process.
Cognitive or behavioural difficulties are present in 30–50% of individuals with Motor Neurone Disease. Behavioural difficulties include repeating phrases or gestures, apathy, and loss of inhibition. Cognitive difficulties include language dysfunction, executive dysfunction, and troubles with social cognition and verbal memory. About half of individuals experience emotional lability, where they cry or laugh for no reason. Around 10–15% will show signs of fronto-temporal dementia. So areas in the brain other than the motor nerves can be affected.
A liability threshold model for Motor Neurone Disease proposes that cellular damage accumulates over time due to inherited genetic factors, combined with the exposure to environmental risks throughout life. Occupations that are associated with Amyotrophic Lateral Sclerosis include military service, farming and white collar jobs (management, financial, architectural, computing, legal, and education). Environmental risks include smoking, alcohol, tobacco, environmental toxins (ie lead, mercury, other heavy metals, pesticides (organochlorine insecticides, aldrin, dieldrin, DDT, and toxaphene)), man-made electromagnetic field exposure, electric shock exposure and moderate to severe traumatic brain injury.
There is no cure for Motor Neurone Disease. A medication called Riluzole may extend life by about two to three months.
Standard medical treatment focuses on treating symptoms and palliative care to improve quality of life and prolong survival, concentrating on respiration assistance as required, physiotherapy to maintain muscle strength and range, and occupational therapy and speech therapy.
Functional medicine treatment considers Motor Neurone Disease as being the group of signs and symptoms that result from an imbalance between neuro-toxic and neuro-trophic factors in the parts of the brain and spine that control voluntary movement. These factors can affect other areas of the brain, hence the behavioural and cognitive dysfunction.
These factors originate from disorder in the brain, the body and/or the environment. By taking a system's biology approach, we identify as many of the causative factors of the neuro-degeneration as possible. This approach allows optimal repair of damaged areas of the brain, leading to increased functioning and symptom reduction. It is currently believed that it is not possible to regrow new motor nerves to replace those killed by the neurotoxins, but one can certainly improve the current function and future survival of the existing motor nerves and reduce the progressive functional decline of Amyotrophic Lateral Sclerosis.
Each individual has their own unique balance of neuro-toxic and neuro-trophic factors that are causing their disorder. Comprehensive history taking, physical examination and testing can identify many of these. Then a tailored management program can be constructed to remediate these factors.
The best results are usually obtained by combining the conventional and functional medicine approaches. This allows optimal symptom control whilst addressing the root causes of the disorder.
We undertake detailed functional, physiological, blood, stool, urine and medical imaging investigations to objectively quantify your state of brain and body health and the factors contributing to it. This involves investigating your whole health including metabolic, cardiovascular, gut health, chronic infections, environmental toxins and many lifestyle factors. We particularly focus on your levels of known neuro-toxins, and the functional health of your body's detoxification pathways that are responsible for metabolising and removing these toxins.
An individualised management program is then formulated to address your biology and lifestyle factors. Depending upon the extent of the nerve damage, and the ability of the patient to make the appropriate changes that are necessary, results can be seen in 6 to 12 months, sometimes sooner.
We find that the more severe the disease, the less recovery that is possible.
For more information about management please call or email our clinic as testing and protocols are highly personalised.