10 Symptoms of ALS

Amyotrophic lateral sclerosis (ALS), commonly referred to as Lou Gehrig's disease, is a rare and debilitating neurological condition characterized by the degeneration and eventual cessation of motor neurons responsible for voluntary muscle function. As the disease progresses, patients experience significant challenges, including difficulties with eating, speaking, moving, and ultimately breathing. Annually, around 5,000 individuals in the United States receive an ALS diagnosis, as reported by the ALS Foundation. While several treatments are available to manage symptoms and improve quality of life, there is currently no cure for ALS.

1. Coordination

Loss of coordination often serves as an early indicator of amyotrophic lateral sclerosis (ALS). Initially, individuals may experience subtle disruptions in hand-eye coordination, manifesting in challenges with everyday tasks such as grasping a hairbrush. As the condition progresses, such coordination difficulties become more frequent. In some instances, these coordination issues may persist for several months before the emergence of other ALS-related symptoms.

2. Cramps

One of the initial indicators of amyotrophic lateral sclerosis (ALS) may be muscle cramps or spasms, which often appear in conjunction with other neurological symptoms. As the condition progresses due to the degeneration of spinal and brain stem motor neurons, individuals may experience muscle twitching, cramping, and atrophy. These symptoms generally emerge following a decline in hand-eye coordination and can persist throughout various stages of the disease.

3. Weak Muscles

Amyotrophic lateral sclerosis (ALS) rapidly affects the nervous system, leading to motor neuron degeneration, which are crucial for voluntary muscle movements. This neuron damage causes progressive muscle weakness and atrophy. Consequently, individuals with ALS may experience significant reduction in muscle mass, often necessitating the use of wheelchairs to aid in mobility even before the complete loss of ambulatory abilities.

4. Vocal Pitch Changes

Laryngeal dysfunction, commonly associated with amyotrophic lateral sclerosis (ALS), can manifest due to the degeneration of neurons impacting the bulbar nerves. This condition frequently leads to a noticeable lowering of voice pitch among individuals afflicted with ALS. Often, this symptom arises in conjunction with challenges in hand-eye coordination.

5. Slurred Speech

Speech slurring occurs due to an impairment of the muscles needed for articulation, such as the lips and tongue, a condition known as dysarthria. This motor dysfunction hinders clear pronunciation and the ability to speak correctly, presenting challenges in verbal communication. Dysarthria is distinct from changes in vocal pitch and relates specifically to the physical capability of forming words.

6. Crying and Laughing Uncontrollably

Patients with ALS may experience pseudobulbar affect, where they have involuntary episodes of laughter or crying due to mood swings. This condition is thought to arise from the degeneration of upper motor neurons in the cerebral cortex and brainstem, leading to compromised neural pathways and a loss of inhibitory control. The resulting emotional expressions are often abrupt and may occur without any apparent cause, varying in duration from a few moments to an hour. There are prescription medications available that can help manage these emotional outbursts and stabilize mood fluctuations.

7. Breathing Problems

As the disease advances in patients with Amyotrophic Lateral Sclerosis (ALS), respiratory complications commonly arise due to the progressive degeneration of muscular function. Initially, individuals may experience symptoms such as difficulty breathing deeply or shortness of breath. Over time, this can lead to more severe respiratory issues, including the possibility of lung collapse, necessitating the continual use of mechanical ventilation support to assist with breathing.

8. Problems with Walking

Difficulty with ambulation is often observed in the advanced stages of Amyotrophic Lateral Sclerosis (ALS). It typically begins with leg muscle weakness that progressively intensifies due to ongoing muscular atrophy associated with ALS. While various conditions can lead to leg weakness, it is usually accompanied by additional symptoms of ALS by the time it becomes pronounced.

9. Problems Swallowing

Difficulty with swallowing, or dysphagea, is a common advanced symptom of Amyotrophic Lateral Sclerosis (ALS). It complicates basic functions like eating and drinking, thus increasing the risk of choking, as even saliva cannot be easily swallowed. This is due to impaired muscle control necessary for swallowing. To address these challenges, physicians may collaborate with nutritionists to create specialized meal plans. These tailored plans are designed to ensure that ALS patients receive adequate nutrition despite their condition.

10. Difficulty Supporting the Head

Individuals with advanced Amyotrophic Lateral Sclerosis (ALS) may experience weakened neck muscles, leading to a condition known as dropped head syndrome. This manifests as a difficulty in controlling neck muscles, necessitating the use of neck braces to provide support and maintain the head in a proper position.

15 Causes of Vertigo

Vertigo manifests as a feeling of spinning experienced by an individual or the perception that the environment is whirling. Medical professionals categorize vertigo into two types: peripheral and central. Peripheral vertigo is associated with the vestibular system within the inner ear and may result from infections, injuries, or adverse reactions to medications. Central vertigo, which is less common, typically arises from issues within the central nervous system. The duration of vertigo episodes can vary, ranging from a few minutes to several hours, and may, in some instances, persist for days.

1. Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV) is a prevalent form of vertigo, often triggered by specific head movements such as bending or turning while in bed. It occurs when minuscule calcium carbonate crystals detach from their usual location in the inner ear, leading to excessive stimulation of the hair cells that detect motion. This can cause the brain to perceive movement erroneously. Typically, the spells of dizziness are brief and do not necessitate medical intervention, though there is a minor risk of falls. BPPV more commonly affects individuals over the age of 50.

2. The labyrinthitis infection

Labyrinthitis is a medical condition characterized by inflammation within the bony labyrinth, a crucial part of the inner ear that oversees auditory and equilibrium functions. This inflammation often results in vertigo. The condition is typically instigated by viral infections, although bacterial infections can also be responsible. Symptoms associated with labyrinthitis include ear pain, hearing impairment, nausea, and occasionally fever.

3. Vestibular neuritis

Vestibular neuritis is a condition characterized by the inflammation of the vestibular nerve, which connects the inner ear's labyrinth to the brain. This inflammation typically follows a viral infection, such as a cold or upper respiratory infection. Symptoms of vestibular neuritis are similar to those of labyrinthitis and may include dizziness, balance issues, and, in some cases, hearing loss—which can be permanent. While symptoms may resolve within a few hours, they can also last for several weeks. The occurrence and severity of vestibular neuritis symptoms can profoundly affect a person's daily activities and overall quality of life.

4. Vertigo caused by an illness

Vertigo can be induced by certain underlying medical conditions. Individuals with multiple sclerosis may frequently face bouts of dizziness, a common manifestation associated with the disease. Likewise, vertigo may be a symptom experienced by those suffering from migraines or diabetes, particularly when diabetes results in atherosclerosis—hardening or narrowing of the arteries—that impedes blood flow to the brain. Furthermore, panic attacks are known to precipitate vertigo episodes.

5. Side effect of pregnancy

During early pregnancy, expectant mothers may experience vertigo due to hormonal fluctuations, which can influence blood sugar levels. Low blood sugar is commonly associated with dizziness. As the pregnancy progresses, lying on the back can also cause vertigo, as this posture allows the growing fetus to compress a major vein, disrupting blood flow to the heart. Typically, vertitude related to pregnancy should resolve after the birth of the baby.

6. Traveling

Vertigo is a common experience after travel, frequently associated with motion sickness from sea or car travel. When an individual steps from a moving vehicle onto solid ground, a transient disturbance in balance may occur, leading to temporary dizziness. This reaction typically resolves swiftly as the body acclimates to a stable environment. In rare instances, however, vertigo can persist for an extended period, particularly among individuals prone to migraines. It is important to seek medical advice if symptoms are prolonged or recurrent.

7. Too much time lying down

Individuals may experience a temporary sensation of vertigo after prolonged periods of lying down, such as during convalescence from illness. This sensation, similar to the feeling one might have after disembarking from a ship, results from the body readjusting to its upright posture and equilibrium. Generally, this form of vertigo dissipates swiftly.

8. Ear surgery

While incidences of vertigo post-ear surgery are uncommon, some individuals may encounter this as a temporary complication. Typically, this condition resolves spontaneously without the need for additional intervention. However, if symptoms persist, patients are advised to report any postoperative issues to their healthcare professional. The doctor will assess the severity of the vertigo and oversee the patient's progress, determining if further medical action is required. Please note that the embedded image is not displayed in this text format.

9. Head or neck injuries

Individuals recovering from a head injury may frequently experience vertigo, with the duration varying based on the injury’s severity and area of impact. It is possible for associated neck injuries to induce cervical vertigo in cases where the nerves or vascular structures are affected. Typically, the body is capable of healing such damage naturally over a period ranging from a few days to several weeks.

10. Genetic factors

Certain inherited conditions can be associated with vertigo. Meniere's disease, an inner ear disorder known to cause hearing impairment and tinnitus, often triggers intense vertigo episodes. It has a genetic component, though it can also occur in individuals without a familial predisposition. Otosclerosis, a less common genetic ear bone disorder, is another potential cause of vertigo. Approximately 50% of otosclerosis cases have a genetic factor that increases the susceptibility to this condition.

11. Central vertigo: beyond the inner ear

Central vertigo is characterized by disturbances originating within the brain, particularly the brainstem or cerebellum, in contrast to its more prevalent counterpart, peripheral vertigo, which arises from inner ear issues. Central vertigo is notably less common but typically indicates more serious neurologic conditions, potentially including stroke or multiple sclerosis. While it shares symptoms with peripheral vertigo, such as dizziness, central vertigo may present additional, more pronounced neurological symptoms, including coordination difficulties or speech impairment. Management strategies target the root cause and can encompass various treatments like pharmacotherapy, rehabilitative physical therapy, or in select cases, surgical interventions.

12. Medication-induced vertigo: the pharmaceutical culprit

Certain pharmaceuticals may inadvertently induce vertigo, a notable side effect associated with various drug classes including certain antibiotics, diuretics, central nervous system agents, antidepressants, contraceptives, antihypertensives, and anti-inflammatory drugs. It is advisable for patients who experience vertigo subsequent to initiating a new medication to seek medical advice. The prescribing physician may consider adjusting the medication regimen. Typically, vertigo symptoms may subside as the patient's body acclimates to the medication or when the course of treatment is complete.

13. Mal de Debarquement Syndrome (MdDS): when the ground keeps moving

Mal de Debarquement Syndrome (MdDS) is a condition marked by a continuous feeling of movement, such as rocking or swaying, that individuals often experience following sea travel or air flights. While the symptoms usually subside within 24 hours, they may persist for months or extend over years and are more prevalent in women. The causes of MdDS remain unclear, and although there is no definitive cure, management strategies including vestibular rehabilitation therapy and medication may alleviate symptoms. Proper diagnosis and awareness of MdDS are essential for individuals facing unexplained, enduring symptoms of dizziness post-travel.

14. Vertebrobasilar insufficiency: a circulatory system concern

Vertebrobasilar insufficiency is a medical condition characterized by reduced blood flow in the vertebral or basilar arteries, which can impair circulation to the posterior region of the brain. Patients with this condition may experience symptoms including vertigo, vision disturbances, slurred speech, and physical weakness. Contributing risk factors for developing vertebrobasilar insufficiency are tobacco use, hypertension, and diabetes. Therapeutic strategies are aimed at enhancing blood flow and might encompass lifestyle modifications, pharmacological treatment, and possibly surgical intervention to mitigate the risk of a cerebrovascular event, such as a stroke.

15. Autoimmune inner ear disease: when the body attacks itself

Autoimmune inner ear disease (AIED) constitutes a rare immune-mediated condition characterized by auditory and equilibrium disturbances, notably hearing loss and vertigo. The diagnostic process is comprehensive and often involves audiological evaluations, serological testing, and occasionally, radiological imaging to properly identify the disorder. Currently, no cure exists for AIED; however, management strategies primarily include corticosteroids to mitigate inflammation and modulate the immune system's activity. Prompt treatment is essential to avert irreversible impairment of the auditory and vestibular systems.

9 Types of Bruises and Everything You Should Know About

A contusion, commonly known as a bruise, manifests as a visible discoloration on the skin, resulting from subdermal hemorrhaging due to broken blood vessels. While often a consequence of physical trauma, bruises can also occur without injury. Characterized by the absence of external bleeding, bruises present a spectrum of shades—including black, purple, brown, blue, or yellow—depending on their age and severity. Although anyone can sustain a bruise, certain individuals may be more susceptible to bruising than others.

1. Hematoma

A hematoma typically develops as a result of an injury, leading to a collection of blood beneath the skin that may feel firm, uneven, or compressible. While hematomas may appear concerning due to their appearance and texture, they are generally not dangerous and do not lead to blood clots. The condition often resolves naturally within a span of one to four weeks without requiring significant medical intervention.

2. Purpura

Purpura refers to small, purple-colored lesions ranging from 4 to 10 mm across that manifest on the skin or mucous membranes, such as within the mouth and throat. These lesions result from the leakage of minute blood vessels, typically presenting as numerous pinpoint dots. Purpura may indicate an underlying medical issue, such as thrombocytopenia (a reduction in platelet count), and might arise from a variety of causes including congenital conditions, adverse drug reactions, or nutritional deficiencies.

3. Petechiae

Petechiae are minute hemorrhagic spots under the skin, closely resembling purpura but distinguished by their size, with petechiae being less than 4 mm in diameter. These small, flat spots are neither painful nor itchy, and unlike rashes, they do not change color when pressure is applied. Their occurrence can be attributed to a variety of factors including thrombocytopenia (a reduced platelet count), the use of certain medications, or more severe underlying conditions such as endocarditis, systemic infections, or leukemia. It is critical to accurately differentiate petechiae from common rashes for appropriate medical evaluation and treatment.

4. Senile Purpura

Age-related changes in the skin can lead to a condition known as senile purpura, characterized by bruising primarily on the hands and forearms of older adults. This occurs due to diminished skin density and increased fragility of blood vessels in the elderly. Such bruises manifest as dark purple patches that may arise without a clear cause and typically resolve within a week, although they can leave a lasting brownish stain on the skin.

5. Black Eye

A black eye typically results from facial trauma and is characterized by bruising around the eye. While most black eyes are relatively benign and heal on their own, they can occasionally indicate more severe injuries such as internal ocular damage, orbital fractures, or even cranial fractures. Prompt medical attention is warranted if additional symptoms like double vision, bilateral bruising (around both eyes), or epistaxis (nosebleeds) accompany the black eye, as these can be signs of a more critical condition.

6. Muscle Contusions

A muscle contusion refers to a bruise that affects the tissues and fibers of the muscle due to a direct impact, distinct from bruises that merely discolor the skin. It is a prevalent sports-related injury. Such trauma can lead to significant swelling and pain, resulting in restricted motion and diminished capacity to bear weight on the affected joint. In more severe cases, substantial hematomas may develop in the injured region.

7. Subcutaneous Bruises

Bruises can be categorized according to their location on the body. Subcutaneous bruises, those occurring just below the skin, typically begin as a red discoloration, transitioning through blue and purple shades, and eventually turning green or yellow as they heal. To mitigate such bruising, immediate application of ice to the affected area and keeping it elevated can be beneficial in reducing the severity and spread of bruising.

8. Intramuscular Bruises

Intramuscular bruises, commonly referred to as muscle contusions, are prevalent among male athletes engaged in highly physical sports such as rugby, football, soccer, and ice hockey. These injuries occur beneath the skin within the muscle tissue and are categorized by varying degrees of severity. While serious complications such as compartment syndrome or rhabdomyolysis are unusual, they are potential risks associated with severe bruising and should be monitored carefully.

9. Periosteal Bruises

Bone bruises, also known as periosteal bruises or microfractures, represent a type of injury where the bone tissue is damaged but not fully broken. Although these injuries are not as critical as fractures, they can cause significant discomfort and pain. Bone bruises can result from a variety of incidents such as vehicular accidents, sports-related traumas, falls, or sprains, leading to the accumulation of blood beneath the periosteum—a thin tissue layer enveloping the bone—or internal bleeding within the bone itself, contributing to swelling at the site of injury.

10. Who Is Prone to Bruising?

Bruising susceptibility varies among individuals due to factors such as genetics, diet, and coordination—affecting how frequently one might sustain minor injuries. Notably, women tend to bruise more easily than men, and the likelihood of bruising increases with age, as older adults have more fragile skin and vascular structures. Medical professionals are attentive to the occurrence of frequent bruising, which can be an important indicator of potential abuse, warranting special vigilance in the care of children and the elderly.

11. Medication

Certain pharmaceuticals may increase the likelihood of bruising. Commonly used over-the-counter medications such as aspirin, ibuprofen, and naproxen have been known to influence clotting times. This is also true for prescription blood thinners, including warfarin and heparin. Furthermore, specific antidepressants, steroids, and certain antibiotics may interfere with the clotting process. It is also important to note that the application of topical steroid creams may lead to skin thinning, which could result in a heightened risk of bruising.

For illustrative purposes, a visual representation of such medications and their effects can be found through various educational resources.

12. When to See a Doctor

Bruising is a natural response to injury, and in most cases, bruises heal independently without intervention. However, persistent or excessive bruising could indicate an underlying medical condition. Some symptoms to be aware of include more frequent bruising than usual or bruises that occur without any known cause. These symptoms can be associated with various health issues, such as thrombocytopenia (low platelet count), functional platelet disorders, or coagulation anomalies. If you are experiencing unusual bruising patterns, it is advisable to consult a healthcare professional for evaluation and appropriate management.