Something is eating away at the nervous systems of military veterans like Mike White and Jeff Long. It started with some tingling and numbness, difficulty walking and poor hand coordination, and it progressed to stumbling and an increasingly limited range of motion.
It’s called amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease, after the baseball player who made it famous (though he’s not the only famous patient — Stephen Hawking also has the condition). ALS attacks the motor neurons in the brain and spinal cord responsible for controlling muscle movement, slowly paralyzing patients over time.
As the disease progresses, they start to need assistance walking, finally needing a wheelchair for mobility. Eventually, patients need assistance with even basic daily tasks, including grooming, using the bathroom and eating. Many patients wind up on ventilators because they are no longer able to breathe independently, with pneumonia and other lung infections being a common cause of death as their immune systems decline and their limited mobility makes it challenging to fight off infections.
Depending on the progression of the disease and the care the patient receives, it can move quickly and ruthlessly, or more slowly. And while a very small percentage of cases appear to have a genetic component, others appear out of the blue.
Still, none of this explain why military veterans, particularly those who served in the First Gulf War, are twice as likely to get it when compared to the rest of the population. Since 2008, the Veterans Administration has recognized that there’s a clear link between ALS and military service, and the agency considers it to be a service-connected disability, meaning that service either causes or exacerbates it. This makes veterans eligible for comprehensive assistance from the VA, but it still doesn’t address the root question: where are all these cases of ALS coming from?
An estimated 2,000 veterans live with ALS today, while as many as 30,000 people overall have the disease. It’s an extremely common motor neuron disease, making it a prime subject for research and development, yet scientists have been unable to pin down specific environmental causes. One study found a possible link between ALS and recreational athletics — the condition is seen in soccer and NFL players, for example, and Iraq veterans tend to have injuries similar to those observed in athletes. It could also be environmental, related to chemical exposure or other factors.
Most likely, it’s a combination of factors that causes proteins to go rogue and start attacking motor neurons. Therapy for ALS is focused on developing treatments that target these proteins, or take another tack, using stem cells to replace damaged motor neurons. While these treatments in development are good news for current patients, everyone is still waiting for the answer to the more fundamental question about the origins of ALS, and whether it could be prevented or mitigated.
Numerous illnesses appear to have mysterious connections to service in the Gulf, including Chronic Fatigue Syndrome and so-called “Gulf War Syndrome.” This could be due to chemical weapons and other toxins that may have been present in the environment, or it could have been caused by the military’s own materials. It’s possible that even the vaccines used might have created problems for servicemembers. Whatever’s causing the increase in neurological diseases, among others, hasn’t been narrowed down, but it’s very real for the veterans struggling with these conditions.
Can researchers and the VA pin down the origins of ALS? It might be important not just for veterans but for civilians, especially those in war zones who may be exposed to the same environmental factors that veterans interact with during their service.
Photo credit: Fort Rucker.