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The focus of treatment for ALS is aimed at relieving symptoms. Even though there is no cure for ALS yet, there are effective treatments to help the patient live with the disease. Sustaining the highest level of function and comfort is an important goal in the management of patients with ALS.

Generally, patients should continue usual daily activities, stopping before they become fatigued. Patients should be encouraged to set their own limits of exertion, and to plan how they will use their energy and strength.

The physician will probably suggest exercises, including breathing exercises, to strengthen unaffected or less-affected muscles. These exercises are not vigorous or tiring, but are intended to help maintain mobility and prevent joint stiffness and muscle contracture.

Various devices such as foot-drop braces, hand splints, limb supports or wheelchairs enable the patient to remain as independent as possible.

Good skin care, massage and knowledge of proper body positioning can prevent sores for those who are confined to bed for lengthy periods of time. If bowel and bladder function are affected by immobility, increasing daily fluid intake should improve the situation or the doctor may prescribe stool softeners, bulk formers or laxatives.

ALS patients who have difficulty speaking may benefit from working with a speech therapist. These health professionals can teach patients adaptive strategies such as techniques to help them speak louder and more clearly. As ALS progresses, speech therapists can help patients develop ways for responding to yes-or-no questions with their eyes or by other nonverbal means and can recommend aids such as speech synthesizers and computer-based communication systems. These methods and devices help patients communicate when they can no longer speak or produce vocal sounds.

A palatal lift may help if there are speech problems.

Drug Treatment Riluzole - Rilutekô is the first and only drug to receive FDA approval for the treatment of ALS. Clinical trials in America and Europe have shown a significant prolongation of tracheotomy-free survival (about 20%) in ALS patients taking Riluzole compared to those taking placebo. Riluzole is a glutamate release inhibitor and it is thought that it works in ALS by decreasing glutamate mediated motor neuron cell death. The dose is 50mg twice a day. Doctors must follow complete blood count and liver function tests every month for 3 months then every 3 months for 9 months.

Source: ALSA

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