The recent death of former international footballer Paraskevas Antzas at the age of 49 has drawn renewed attention to Amyotrophic Lateral Sclerosis (ALS), a severe neurodegenerative disease that currently has no cure.

ALS, also known as Motor Neuron Disease, is a progressive neurological condition that affects the nerve cells responsible for controlling voluntary muscle movements. As these motor neurons gradually deteriorate, they lose the ability to transmit signals to muscles, leading to weakness, muscle wasting and increasing physical disability.

What Is ALS?

ALS primarily targets motor neurons, the specialized nerve cells that control movements such as walking, speaking, swallowing and breathing. As the disease progresses, muscles weaken and gradually lose function.

While ALS can severely affect physical abilities, cognitive functions are generally preserved in most patients.

There are two main forms of the disease:

• Sporadic ALS, the most common type, accounting for approximately 90% to 95% of cases and occurring without a clear inherited cause.
• Familial ALS, an inherited form of the disease that represents around 5% to 10% of cases and is passed through families.

Although the exact cause remains unclear, factors such as genetic predisposition, environmental exposure and age are believed to contribute to the development of the disease.

Early Signs and Symptoms

One of the challenges of ALS is that its initial symptoms are often subtle, making early diagnosis difficult.

Common early signs include:

• Muscle weakness in the limbs, hands or muscles involved in speech and swallowing
• Muscle twitching and involuntary movements, particularly in the arms and legs
• Difficulty performing precise movements, such as buttoning clothes or turning a key
• Changes in speech, including slurred speech or hoarseness
• Muscle cramps and stiffness that worsen over time

In many cases, symptoms begin in a single limb before gradually spreading to other parts of the body.

How the Disease Progresses

ALS generally advances through four stages, with symptoms becoming increasingly severe over time.

Early Stage: Patients experience mild muscle weakness and occasional cramps while remaining largely independent in daily activities.

Middle Stage: Muscle weakness becomes more pronounced and spreads throughout the body. Mobility declines, and patients may require walking aids. Difficulties with speaking and swallowing often emerge.

Advanced Stage: Extensive paralysis and significant loss of mobility develop. Breathing and nutrition frequently require medical support, while communication becomes increasingly challenging.

End Stage: Patients become fully dependent on caregivers. Respiratory failure is the leading cause of death, and palliative care plays a central role in maintaining comfort and quality of life.

Life Expectancy and Available Treatments

The average life expectancy following an ALS diagnosis is between three and five years, although progression can vary significantly from one individual to another.

While there is no definitive cure, medications such as riluzole and edaravone may help slow disease progression. Physiotherapy, supportive medical care and assistive technologies can also improve quality of life and help patients maintain independence for as long as possible.

Understanding the Challenges

ALS remains one of the most serious neurodegenerative disorders, requiring continuous medical support and care. Greater awareness of its symptoms, stages and progression can help patients, caregivers and families better prepare for the challenges associated with the disease while ensuring access to appropriate treatment and support services.