Amyotrophic Lateral Sclerosis: A Closer Look at the Silent Struggle

Dahyun Kim

April 18, 2025

The ice bucket challenge, related to the viral “USC mind challenge”—made to spread mental health awareness—was originally made to spread awareness of a disease called Amyotrophic Lateral Sclerosis 10 years ago and collect donation funds for deeper research into this rare disease. 

Amyotrophic Lateral Sclerosis, shortened ALS, is a disease that occurs in the nervous system, affecting the nerve cells in the brain and spinal cord. ALS is often known as “Lou Gehrig disease" as it ended the career of Lou Gehrig, a beloved baseball player, in 1941. Widely known symptoms for ALS vary by individuals, depending on the affected nerve cells. However, ALS generally starts with muscle weakness and spreads throughout the body. ALS affects the nerve cells that are in charge of voluntary muscle movements, called motor neurons, which are divided into two groups—upper motor neurons and lower motor neurons. Upper motor neurons extend from the brain to the spinal cord to muscles throughout the body, and the lower motor neurons extend from the spinal cord to muscles. Patients’ motor neurons will gradually deteriorate and die as the motor neurons are damaged, unable to transfer messages to muscles. It is found that about 10% of people with ALS can identify the genetic cause, and 90% of the causes are unknown. It is also hard to diagnose one with ALS by themselves, as the symptoms are not necessarily unique to ALS. 

Some of the symptoms listed according to the Mayo Clinic are: Trouble walking or doing usual daily activities, tripping and falling, weakness in the lower body, hand weakness, slurred speech or trouble swallowing, and weakness related to muscle cramps and twitching in the arms/shoulders/tongue. Typically, the ALS often starts off from the hands, feet, arms, or legs, then later spreads to the smaller muscles of the body, causing the muscles to weaken as more nerve cells die, eventually affecting chewing, swallowing, speaking, and breathing. ALS is hard to detect in the early stage, as there is no pain associated with this disease—pain is not common in either the early or the later stage, as it does not affect bladder control. 

The treatment and the way to find the other 90% of the cause of ALS have not been discovered yet. However, some of the risk factors are age, genetics, sex, and environmental factors. ALS is specifically risky for ages between 60 and the mid-80s, the risk increasing up to age 75. Before the age of 65, women develop ALS more than men; however, this disappears past the age of 70. Genetically, about 10% of the people with ALS had it passed down by a family member, known as hereditary ALS. This means that their children have a 50% chance of inheriting ALS later in life. Some of the environmental factors are associated with smoking, toxin exposure, and military service—exposure to certain metals or chemicals, injuries, infections, or intense exertion. The treatment and the methods to diagnose a wider range of ALS patients are in the process of being studied, and will be discovered deeper moving on. It is important for us to be aware of these diseases under the veil, in ways such as the ice bucket challenge and donations to organizations.