Ann Hughes

ALS is characterized by the progressive destruction of upper and lower motor

neurons, which directly control muscle. The disease process does not affect
occulomotor (III), Trochlear (IV), and Abducens cranial nerves. These cranial nerves
control constriction of the pupil, maintaining an open eyelid, controlling the superior
oblique muscle of the eye, and the lateral rectus muscle of the eye. Because these
motor nerves are not typically affected some movements, such as blinking, persist.
Because the disease only affects motor neurons, intellectual and sensory functions
are also not affected (Munson & Traister, 2005). According to Patricia G Moyer
Shannon, MD, MEd, Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s
disease, is named because of its pathophysiology. The Amyotrophy refers to
muscles which Progessively atrophy when they are denervated as their
corresponding anterior horn cells degenerate. The Lateral sclerosis portion of the
name also refers to hardening of the anterior and lateral columns of the spinal cord
as motor neurons in these areas are replaced by fibrous astrocytes (gliosis)when
they degenerate ( Moyer Shannon, MD, MEd, 2009).

Risk Factors:

Established risk factors for ALS include:

Heredity. Up to 10 percent of the people who have ALS inherited it from their
parents. If you have this type of ALS, your children have a 50-50 chance of
developing the disease.

Age. ALS most commonly occurs in people between the ages of 40 and 60.

Sex. Before the age of 65, slightly more men than women develop ALS. This sex
difference disappears after age 70.

It may be that ALS, similar to other diseases, is triggered by certain environmental

factors in people who already carry a genetic predisposition to the disease. For
example, some studies examining the entire human genome (genome-wide
association studies) found numerous genetic variations that people with ALS held in
common, and that might make a person more susceptible to ALS.

Environmental factors under study that may modify a person's individual risk of ALS
include:

Smoking. Smoking cigarettes appears to increase a person's risk of ALS to almost

twice the risk of nonsmokers. The more years spent smoking, the greater the risk.
On the other hand, quitting smoking can eventually lower this increased risk to that
of a nonsmoker.

Lead exposure. Some evidence suggests that exposure to lead in the workplace
may be associated with the development of ALS.

Military service. Recent studies indicate that people who have served in the military
are at higher risk of ALS. Exactly what about military service may trigger the
development of ALS is uncertain, but it may include exposure to certain metals or
chemicals, traumatic injuries, viral infections and intense exertion.

References

Moyer Shannon, MD, MEd, P. G. (2009, March 12). Amyotrophic Lateral Sclerosis.
Retrieved January 14, 2011, from emedicine from WebMD:
http://emedicine.medscape.com/article/306543-overview
Amyotrophic lateral sclerosis. (2010, November 5). Retrieved January 13,
2011, from MayoClinic.com: http://www.mayoclinic.com/health/amyotrophic-
lateral-sclerosis/DS00359/DSECTION=risk-factors
Black, J. M., & Hawks, J. H. (2009). Medical - Surgical Nursing; Clinical
Management for Positive Outcomes (8th ed.). St. Louis: Saunders, an imprint
of Elsevier Inc.
Munson, C., & Traister, R. (Eds.). (2005). Pathophysiology: A 2-in-1 Reference
for Nurses. Philadelphia: Lippincott Williams & Wilkins.