Primary lateral sclerosis is a type of motor neuron disease that causes muscle nerve cells to slowly break down, causing weakness. Primary lateral sclerosis (PLS) causes weakness in your voluntary muscles, such as those you use to control your legs, arms and tongue.
Primary lateral sclerosis can happen at any age, but it usually occurs between ages 40 and 60. A subtype of primary lateral sclerosis, known as juvenile primary lateral sclerosis, begins in early childhood and is caused by an abnormal gene passed from parents to children.
Primary lateral sclerosis is often mistaken for another, more common motor neuron disease called amyotrophic lateral sclerosis (ALS). However, primary lateral sclerosis progresses more slowly than ALS, and in most cases isn't fatal.
Source: http://www.mayoclinic.com
Signs and symptoms of primary lateral sclerosis (PLS) usually take years to progress. They include:
Less commonly, PLS begins in your tongue or hands and then progresses down your spinal cord to your legs.
Make an appointment to see your doctor if you have persistent problems with stiffness or weakness in your legs, or with swallowing or speaking.
If your child develops involuntary muscle spasms or seems to be losing balance more often than usual, make an appointment with a pediatrician for an evaluation.
Source: http://www.mayoclinic.com
In primary lateral sclerosis (PLS), the nerve cells in the brain that control movement fail over time. This loss causes movement problems, such as slow movements, balance problems and clumsiness.
The cause of adult primary lateral sclerosis is unknown. In most cases, it's not an inherited disease, and it's not known why or how it begins.
Juvenile primary lateral sclerosis is caused by mutations in a gene called ALS2.
Although researchers don't understand how this gene causes the disease, they know that the ALS2 gene is responsible for giving instructions for creating a protein called alsin, which is present in motor neuron cells.
When the instructions are changed in someone with juvenile PLS, the protein alsin becomes unstable and doesn't work properly, which in turn impairs normal muscle function. Adults who get primary lateral sclerosis don't appear to have the same gene mutation.
Juvenile primary lateral sclerosis is an autosomal recessive disease, meaning that both parents have to be carriers of the gene to pass it to their child, even though they don't have the disease themselves.
Source: http://www.mayoclinic.com
There is no single test that confirms a diagnosis of primary lateral sclerosis (PLS). In fact, because the disease can mimic signs and symptoms of other neurological diseases such as multiple sclerosis and ALS, your doctor may order several tests to rule out other diseases.
After taking a careful record of your medical history and family history and performing a neurological examination, your doctor may order the following tests:
Magnetic resonance imaging (MRI). An MRI or other imaging tests of your brain or spine may reveal signs of nerve cell degeneration.
Your doctor may also order an MRI to look for other causes of your symptoms, such as structural abnormalities, multiple sclerosis or spinal cord tumors.
Electromyogram (EMG). During an EMG, your doctor inserts a needle electrode through your skin into various muscles. The test evaluates the electrical activity of your muscles when they contract and when they're at rest.
This test can measure the involvement of lower motor neurons, which can help to differentiate between PLS and ALS.
After other diseases are ruled out, your doctor may make a preliminary diagnosis of PLS.
Sometimes doctors wait three to four years before giving a diagnosis, because early amyotrophic lateral sclerosis (ALS) can look just like PLS until additional symptoms surface a few years later. You may be asked to return for repeat electromyography testing over three to four years before the PLS diagnosis is confirmed.
Source: http://www.mayoclinic.com
Although the average progression of primary lateral sclerosis (PLS) lasts around 20 years, the disease has highly variable effects from person to person. Some people may be able to continue to walk, but others will eventually need to use wheelchairs or other assistive devices.
Adult PLS isn't thought to shorten life expectancy, but it may gradually affect the quality of your life as more muscles become disabled. Weaker muscles may cause you to fall more, which may result in injuries.
Source: http://www.mayoclinic.com
Although there's no cure for primary lateral sclerosis, you can make a few lifestyle choices to preserve muscle function for as long as possible:
Stay active. Continue activity or exercise programs as long as you can comfortably and safely do so. Staying active may help you keep your existing function and slow the progression of the disease.
Be sure you stay safe, keeping in mind that your muscle weakness puts you at higher risk of tripping and falling.
Source: http://www.mayoclinic.com
Periods of feeling down about having primary lateral sclerosis are expected and normal. Dealing with the reality of an incurable, progressive disease can be challenging. To cope with the disease and its effects, consider these tips:
Seek emotional support. Family and friends can be great sources of comfort and support when you're wrestling with the emotional aspects of long-term disease.
Because primary lateral sclerosis is an uncommon diagnosis, it might be a challenge to find a local support group for people with your condition. However, some online discussion groups are available, and it may be helpful to see how others have coped with the disease.
Know and use resources available to you. If you reach a point where your disease is restricting your activities significantly, ask your doctor about devices designed to help you stay independent.
In addition, there are social services available to people with disabilities of all kinds. Try to learn all you can about the resources available to you. Sometimes relying on your community for help can strengthen ties in new ways.
Source: http://www.mayoclinic.com
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