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Amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis
Synonyms Lou Gehrig's disease, Charcot disease
ALS Coronal.jpg
An MRI with increased signal in the posterior part of the internal capsule which can be tracked to the motor cortex consistent with the diagnosis of ALS
Classification and external resources
Specialty Neurology
ICD-10 G12.2
ICD-9-CM 335.20
OMIM 105400
DiseasesDB 29148
MedlinePlus 000688
eMedicine neuro/14 emerg/24 pmr/10
Patient UK Amyotrophic lateral sclerosis
MeSH D000690
Orphanet 803

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease and motor neurone disease (MND), is a specific disease that causes the death of neurons which control voluntary muscles. Some also use the term "motor neuron disease" for a group of conditions of which ALS is the most common. ALS is characterized by stiff muscles, muscle twitching, and gradually worsening weakness due to muscles decreasing in size. This results in difficulty in speaking, swallowing, and eventually breathing.

The cause is not known in 90% to 95% of cases. About 5–10% of cases are inherited from a person's parents. About half of these genetic cases are due to one of two specific genes. The diagnosis is based on a person's signs and symptoms with testing done to rule out other potential causes.

No cure for ALS is known. A medication called riluzole may extend life by about two to three months.Non-invasive ventilation may result in both improved quality and length of life. The disease usually starts around the age of 60 and in inherited cases around the age of 50. The average survival from onset to death is two to four years. About 10% survive longer than 10 years. Most die from respiratory failure. In much of the world, rates of ALS are unknown. In Europe and the United States the disease affects about two people per 100,000 per year.

Descriptions of the disease date back to at least 1824 by Charles Bell. In 1869, the connection between the symptoms and the underlying neurological problems was first described by Jean-Martin Charcot, who in 1874 began using the term amyotrophic lateral sclerosis. It became well known in the United States in the 20th century when in 1939 it affected the baseball player Lou Gehrig and later worldwide when physicist Stephen Hawking, diagnosed in 1963 and expected to die within two years, became famous. In 2014, videos of the ice bucket challenge went viral on the World Wide Web and increased public awareness of the condition.

Type OMIM Gene Locus Inheritance Remarks
ALS1 105400 SOD1 21q22.1 autosomal dominant (?), autosomal recessive (?) The most common form of familial ALS
ALS2 205100 ALS2 2q33.1 autosomal recessive (?) Juvenile-onset
ALS3 606640 (?) 18q21 (?)
ALS4 602433 SETX 9q34.13 autosomal dominant (?)
ALS5 602099 SPG11 15q21.1 autosomal recessive (?) Juvenile onset
ALS6 608030 FUS 16p11.2 (?)
ALS7 608031 (?) 20p13 (?)
ALS8 608627 VAPB 20q13.3 autosomal dominant (?)
ALS9 611895 ANG 14q11.2 (?)
ALS10 612069 TARDBP 1p36.2 autosomal dominant (?) ALS with or without frontotemporal dementia
ALS11 612577 FIG4 6q21 (?)
ALS12 613435 OPTN 10p13 (?)
ALS13 183090 ATXN2 12q24.12 autosomal dominant (?) Spinocerebellar ataxia 2
ALS14 613954 VCP 9p13.3 (?) Recent new study shows strong link in ALS mechanism
ALS15 300857 UBQLN2 Xp11.21 X-linked dominant (?) Described in one family
ALS16 614373 SIGMAR1 9p13.3 autosomal recessive (?) Juvenile onset, very rare, described only in one family
ALS17 614696 CHMP2B 3p11.2 autosomal dominant (?) Very rare, reported only in a handful of people
ALS18 614808 PFN1 17p13.2 (?) Very rare, described only in a handful of Chinese families
ALS19 615515 ERBB4 2q34 autosomal dominant (?) Very rare, as of late 2013 described only in four people
ALS20 615426 HNRNPA1 12q13.13 (?) Very rare, as of late 2013 described only in two people
ALS21 606070 MATR3 5q31.2 autosomal dominant (?) Very rare. Formerly known as "distal myopathy type 2" (MPD2) and "vocal cord and pharyngeal dysfunction with distal myopathy" (VCPDM)
ALS22 616208 TUBA4A 2q35 autosomal dominant (?) "Amyotrophic lateral sclerosis 22 with or without frontotemporal dementia"
FTDALS1 105550 C9orf72 9p21.2 autosomal dominant (?) "Frontotemporal dementia and/or amyotrophic lateral sclerosis type 1". Accounts for around 6% of ALS cases among white Europeans
FTDALS2 615911 CHCHD10 22q11.23 autosomal dominant (?) "Frontotemporal dementia and/or amyotrophic lateral sclerosis type 2"
FTDALS3 616437 SQSTM1 5q35.3 autosomal dominant (?) "Frontotemporal dementia and/or amyotrophic lateral sclerosis type 3"
FTDALS4 616439 TBK1 12q14.2 autosomal dominant (?) "Frontotemporal dementia and/or amyotrophic lateral sclerosis type 4"



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