Actor Eric Dane, widely recognised for his roles in popular television series like Grey's Anatomy and Euphoria, shared a deeply personal health update earlier this year. The star revealed he has been diagnosed with Amyotrophic Lateral Sclerosis (ALS), a progressive neurological disorder. This announcement has brought significant public attention to this rare condition, highlighting the challenges faced by those living with it.
What is ALS and How Does It Affect the Body?
Amyotrophic Lateral Sclerosis, commonly known as ALS or Lou Gehrig's disease, is a severe condition that attacks the body's motor neurons. These are the nerve cells in the brain and spinal cord responsible for controlling voluntary muscle movements. As the disease progresses, these neurons degenerate and die, leading to a gradual loss of muscle function.
The disease specifically targets both the upper motor neurons in the brain and the lower motor neurons in the brainstem and spinal cord. This dual attack results in a combination of symptoms: muscle stiffness and spasticity from upper neuron loss, and muscle wasting, weakness, and twitching (fasciculations) from lower neuron loss. Importantly, ALS typically does not affect senses like sight and hearing, and bowel and bladder control are usually preserved until the very late stages. The heart muscle also remains largely unaffected.
Approximately 2 out of every 100,000 people are diagnosed with ALS annually. In about 80% of cases, the initial symptoms manifest in the limbs, causing weakness in the arms or legs. The remaining 20% experience "bulbar onset," where the first signs involve muscles controlling speech and swallowing.
Recognising the Early Signs and Symptoms
Early detection of ALS can be challenging, but there are key warning signs to watch for. For limb-onset ALS, initial symptoms often include foot drop (difficulty lifting the front part of the foot), hand clumsiness, and a weakening grip, leading to dropping objects. Muscle twitches under the skin and cramps are also common early indicators.
For bulbar-onset ALS, the first signs usually involve slurred speech and difficulty swallowing, which can lead to choking. Other symptoms patients may experience include frequent tripping, general fatigue from routine tasks, and pseudobulbar affect—involuntary episodes of laughing or crying.
Diagnosis involves a thorough clinical examination and tests to rule out other conditions. Neurologists typically use a combination of Electromyography (EMG) to assess nerve and muscle function and MRI scans to look for other possible causes of the symptoms.
Causes, Progression, and Management of ALS
The exact cause of most ALS cases remains unknown. The majority (90-95%) are sporadic, with no clear family history, and are thought to result from a complex mix of genetic susceptibility, environmental factors, and cellular stress. Only 5-10% of cases are familial, linked to inherited genetic mutations like in the SOD1 or C9orf72 genes. Identified risk factors include a history of military service, smoking, and prior head trauma.
The progression of ALS varies but is generally relentless. Many patients with limb onset lose the ability to walk independently within the second year. Bulbar-onset often progresses more rapidly, affecting speech and nutrition sooner. As the muscles of the diaphragm weaken, respiratory failure becomes the primary concern, usually between the third and fifth year. Respiratory failure is the cause of death in about 80% of ALS patients. The average survival time post-diagnosis is two to five years, though some individuals live for decades, especially with slower-progressing forms and comprehensive care.
While there is no cure for ALS, several treatments can help manage symptoms and slow progression. The drug riluzole can extend survival by several months by reducing glutamate levels. Edaravone, an antioxidant, has been shown to slow functional decline by about 33% in some patients. A newer combination therapy, Relyvrio, targets multiple disease mechanisms but availability can vary.
Daily management is multidisciplinary. Physical and occupational therapy help maintain mobility and independence. Speech therapy and communication devices assist when speaking becomes difficult. Feeding tubes (PEG) are often recommended to ensure proper nutrition and prevent aspiration pneumonia. As breathing weakens, non-invasive and later invasive ventilation can support respiratory function, improving quality of life and survival.
Eric Dane's diagnosis in his 50s suggests a potentially different progression trajectory compared to onset at an older age. His journey, alongside ongoing global research into stem cell and gene therapies, continues to shine a light on the urgent need for better treatments and ultimately, a cure for this challenging disease.
