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52 year old female (gulf war veteran) complains of not being able to do…
52 year old female (gulf war veteran) complains of not being able to do normal tasks anymore. She plays pool in an amateur league is having a hard time being able to hold the pool stick and hit the ball as hard as she could previously. Grocery shopping has become difficult because her legs get tired very easily causing her trip and fall, hurting her knee. Patient states the she has family history of amyotrophic lateral sclerosis (ALS). Her brother died at the age of 31 and not confirmed believes her father also died from ALS. Genetic testing confirms that the patient also has ALS. Is this disease treatable? What is the likely progression of this disease?
Upstream
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Indirect causes
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90%-95% of getting ALS is unknown, sporadic
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Physiology
Brain
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Diencephalon
relays sensory information between brain regions and controls many autonomic functions of the peripheral nervous system
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Brain stem
Keeps you alive
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Medulla oblongata
reflex centers for vomiting swallowing, and other GI function
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Neurons
Electrically excitable cells in the nervous system that function to process and transmit information
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Types of neurons
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Sensory neurons
Taste, smell, hear, see, and feel things around you
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Spinal cord
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To coordinate reflexes (quick responses to outside stimuli) that don't go through the brain and are managed by the spinal cord alone
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To relay messages from the brain to different parts of the body (usually a muscle) in order to perform an action
Motor neuron inside the spinal cord fires, an impulse goes out from it to the muscles
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Process of movement
Information from the brain, a cortical region known as the primary motor cortex, needs to travel to the muscles
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consists of upper motor neurons extending from the cortex to the brainstem or spinal cord that make up two major pathways of voluntary movement
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located in the frontal lobe of the brain, along a bump called the precentral gyrus
basal nuclei and cerebellum play essential roles in the control of movement through their interaction with motor-related areas of the cerebral cortex
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Cerebellum
coordinates voluntary movements such as posture, balance, coordination, and speech, resulting in smooth and balanced muscular activity
Downstream
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No cure has been found
Treatments available that can help control symptoms, prevent unnecessary complications, and make living with the disease easier
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Anatomy
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Spinal Cord
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Gray and white matter
Gray matter is filled with neuron cell bodies, dendrites and unmyelinated axons
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