Amyotrophic lateral sclerosis: Pathogenesis, differential diagnoses, and potential interventions

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative motor neuron disease. The etiology is likely multifactorial, involving both genetic and environmental factors. Method: Literature review. Findings: Motor neuron death is believed to arise from mutations in superoxide dismutase 1. Abnormal neurofilament metabolism, glutamate transporter dysfunction, and altered responses to growth factors may play a role. These discoveries have highlighted possible interventions, several of which have subsequently undergone human clinical trials. These include studies of antioxidants, antiglutamatergic agents, cyclooxygenase inhibitors, and various growth factors. Conclusion: Findings are inconclusive, and further investigations are underway. At present, nonpharmacologic interventions such as nutritional support; physical, speech, and occupational therapy; and respiratory management offer the best means of improving quality of life for patients with ALS.