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Amyotrophic Lateral Sclerosis (ALS)

Virginia Mason's multidisciplinary amyotrophic lateral sclerosis (ALS) clinic was the first in Washington state to become certified by the ALS Association and is the only Gold-Standard Certified ALS clinic in the Northwest. Its skilled and experienced team provides compassionate and comprehensive care to patients and families from as far away as Idaho, Alaska and Montana.

For more information about ALS care at Virginia Mason or to schedule an appointment, please call us, (206) 341-0420.

What is ALS?

Amyotrophic lateral sclerosis affects the parts of the nervous system that control voluntary muscle movement. Also known as Lou Gehrig's disease, named after the baseball player who had the disease, ALS causes motor neurons to die gradually and no longer signal the muscles to move. As a result, muscles atrophy and become progressively weaker.

Symptoms of ALS

ALS symptoms usually do not develop until after age 50 and include a loss of muscle strength and coordination that continues to worsen. Breathing or swallowing muscles may be the first affected. Eventually, patients lose the ability to do routine tasks, such as using steps or getting out of a chair. Intellectual ability, as well as hearing, vision and touch, generally function normally.

What Causes ALS?

Investigation continues into possible causes of the disease. Approximately one in 10 cases may be inherited, but the majority appear to occur randomly.

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Diagnosing ALS

ALS can be difficult to diagnose because symptoms may resemble other neurological disorders. A conclusive diagnosis is based on a careful medical history, a physical exam of the nervous system and tests of nerve and muscle function.
Physicians who diagnose ALS at Virginia Mason are board-certified and fellowship-trained in treating disorders of the nervous system. The most thorough ways of diagnosing and treating ALS are used, as well as the collective experience of the many physicians, nurses and therapists who contribute their expertise to every case.

Treatment for ALS

There's no known treatment for reversing the course of ALS. Therapies mainly work to slow the progression of symptoms and make patients more comfortable and independent.


The drug riluzole (Rilutek) was approved in the mid-1990s to treat ALS. It is thought to work by inhibiting the levels of glutamate, which can be toxic to nerve cells when present in excessive amounts. Other drugs that interfere with the synthesis, release or cellular reception of glutamate continue to be studied and tested. In addition, compounds that reduce inflammation, nourish nerve cells or reduce the emotional symptoms of ALS are being researched.

Medications may also be prescribed to help relieve ALS symptoms such as:

  • Fatigue
  • Muscle cramps
  • Pain
  • Excessive salivation
  • Depression

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By evaluating a patient's individual strength and general mobility skills, physical therapists can provide guidance and strategies for maximizing movement. Physical therapists can help patients adjust to changing physical abilities, enhance existing function, slow further loss of motion and help prevent pain. Physical therapy exercises usually target stretching and improving range of motion.

Other therapies that help with ALS include:

  • Occupational therapy — An occupational therapist specializes in working with assistive devices that can help ALS patients stay more mobile and independent.
  • Speech therapy — Because ALS affects the muscles used in speech, a speech therapist can teach techniques for improving the ease and clarity of speaking. Virginia Mason also offers voice banking, a way to preserve the sound of a patient’s own voice to use after real speech is no longer possible. Learn more about voice banking »»

Living with ALS

Coping with a chronic condition such as ALS can be an emotional drain for patients and their families. A new diagnosis means preparing for a period of mourning and grief before being ready to move on and face a new future. Virginia Mason’s ALS clinic is the only one in the state to have a palliative care, board-certified neurologist on staff. This allows the team to be even more focused on providing care aligned with your values and preferences.

The Neuroscience Institute at Virginia Mason can connect patients with resources to help them better cope with the disease. Social workers who specialize in managing chronic illness are available to help locate counseling services, financial support, home health care and other community resources.

Many people with ALS find comfort in a support group with others who have the disorder. Family and friends may also benefit from a support group for caregivers. Find support groups in your area by talking to the Neuroscience Institute care team or by contacting the ALS Association.

For more information about ALS care, contact Virginia Mason's Neuroscience Institute, (206) 341-1900.

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