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LuckyDuck

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CALS
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CA
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B.C.
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North Vancouver
Hello everyone, we are new members.

I am a caregiver, and my wife was newly diagnosed last October, 2008.

My question is: has anyone experienced the onset of ALS after head trauma? We were in a car accident late August 2007 - we were in a taxi which was completely stopped in a construction zone. The car behind us, travelling at significant speed, rear-ended our taxi which then collided with the car stopped in front of us. We both experienced severe double whiplash. My wife's first ALS symptoms (difficulty walking) began to appear in December 2007. Today, (March 31, 2009) she can barely walk.

Her health comes first and we are doing everything in that regard. But we still feel that the accident was a precipitating factor/cause of the onset of my wife's ALS. Our theory is that when the nervous system is jarred violently, anything can happen subsequently, and if one has the underlying pre-disposition towards developing anything (like ALS), head trauma may lead to other neurological developments and/or illnesses.

Therefore, we are debating whether to litigate against the driver who hit us, because we believe the accident caused the onset of the ALS. It's a big decision for us.

Since my wife's diagnosis, we have heard numerous anecdotal cases of individuals like us, who experience head trauma and subsequently develop ALS. However, a search of the medical literature on the Internet, shows a distinct lack of clinical investigative studies being able to conclusively PROVE a connection between trauma and ALS.

I am writing to ask your help: do you or anyone you know have ALS as a result of trauma similar to our experience?

Is there any clinical research supporting this hypothesis?

Thank you for your help.

Buddha John
 
I suggest you find your retirement income some other way. ....LOL.

There is no evidence that head trauma could, or does, cause ALS. No one knows what the cause of ALS is.
Lots of speculation goes on because of the void of knowledge on what causes it.

I am very sorry for your wife's diagnosis of ALS but you will not win a lawsuit blaming the accident on it.

Sorry I can not be the bearer of good news for you!

Oh, and welcome to the forum, sorry you have to be here.
 
First of all let me say, I am so sorry for your wife's diagnosis but welcome to the forum. You will find great advice and support here.

Often it does seem that some form of trauma or a specific incident can trigger or accelerate ALS. My Dad is convinced that his ALS was caused my the statin inhibiting drug Lipitor. He was prescribed Lipitor following an angiogram. It was a precautionary measure because he did not even have high cholesterol but that is precisely when all his troubles began. The timing definitely would suggest that either the angiogram or the Lipitor caused his ALS however there is absolutely no scientific evidence to back up his suspicions. Many doctors advise patients with ALS to avoid Lipitor because it is known to cause the degradation of muscle tissues and sometimes excruciating pain which my Dad experienced right away.

I have also heard that head trauma can accelerate ALS progression but as to its cause, that is still at the study stage at this point. There have been articles in medical journals (the American Journal of Epidemiology to name one) and even an American medical study to determine if repeated head injury was the reason for a higher incidence of ALS in soccer players. I'm not sure you would have a solid legal case in court but to answer your question yes I have found evidence of medical research exploring this hypothesis.

Hang in there!
 
I too believe that head trauma is certainly a factor for ALS. My husband's original doctor - who first suspected that he had ALS - said that there were theories out there that significant head trauma was traced back in many cases of an ALS diagnosis. There are also theories out there that chemical exposure has a significant effect, and can cause (?) ALS. My husband (who passed away July 2, 2008 age 47) had 2 severe concussions - one from sports, and one from a bad vehicle accident, plus he was a firefighter at CFB Suffield (know for its cache of buried WW1 and WW2 chemicals used in chemical warfare - and for its Defense Research labs).

My husband had no history of this disease in his family, and was very fit - he took very good care of himself. Maybe I'm grasping at straws trying to understand why he was afflicted and died from this terrible disease at such a young age - but there has to be a reason! Also, many firefighters get ALS - one has to wonder if their job has anything at all to do with it - whether it's from chemical exposure or from being hurt on the job as these brave men and women give it their all - very dedicated professionals.

Just my two cents...
Beaner
 
Hi Buddha,

I have to disagree with Joelc on this one. There is plenty of circumstantial evidence that head trauma may trigger ALS. Most notably the Italian soccer player study which, I believe, showed a 3x higher incidence than expected. Not sure about the figure. Anecdotally, I have long suspected a connection in my case. In July 1994 I severely injured my neck and head in a diving accident. I was told by the attending emergency room doctor that I was very lucky to have avoided breaking my neck. Late that fall I developed my first ALS symptoms. I certainly can't prove it and I doubt very much that your wife can either. After all, the Taser Corporation has successfully withstood any court challenges that their weapon has caused any deaths. If the courts can't be convinced in the face of what seems like overwhelming evidence, what chance is there of showing an ALS-head trauma causal relationship. I suggest you save your legal fees for upcoming disability expenses. There will be plenty.

I'm sorry to hear about your wife but this is a good place to be on your journey.

John
 
This is only my opinion and I wish you all the best....

The ALS was already on its way. Think about it. She had symptoms before the accident. But the accident could have helped to accelerate her progression. I have been told that trauma or stress can do that. I wholeheartedly believe you can't claim the other driver in the car accident for her ALS: but maybe for the faster progression. I don't know. I'd talk to a lawyer first.

However, my husband was involved in an explosion that almost took his leg. He had 5 surgeries the first week, and a subsequent bone graft surgery later. He still has very slow progression with the ALS. So, you see, Rick's trauma didn't change his ALS for the worse.

I am so sorry you are both having to deal with all this. I just hope you can recover from the accident and all it involved and try to live peacefully in your journey. To make it work you must have strength, courage, patience and peaceful living... along with a positive attitude. It's difficult but attainable.
 
This is only my opinion and I wish you all the best....The ALS was already on its way. Think about it. She had symptoms before the accident...

No, her symptoms showed up many months later as I read Buddha John's post. The accident was in August 2007 and the symptoms first showed in December 2007.
 
Given that ALS is an insidious disease and symptoms aren't typically noticed until something profound has occured (e.g. foot drop or not being able to hold a pen or turn a key, which would all be caused by profoundly weak and most likey atrophied muscle), the disease process was more than likely well on its way prior to the trauma. Therefore, I have to agree with Marjorie that trauma could have accelerated the progression for a short time so that the symptoms were then more noticeable.

Furthermore, if the premise behind the increased ALS incidence of Italian soccer players was due to head trauma, then why is it that just Italian soccer players were affected in this manner; why are other soccer teams not equally affected. There must be more to the story. On top of that, there are other sports much more violent than soccer, such as American football or boxing where the head is hit much more often and much harder . . . and being a huge football and boxing fan, I would have heard about an increased incidence of ALS in those sports. I know of only one professional football player that has ALS and not a single boxer. I have yet to actually read that "soccer" study, so I'm not sure if it is a valid or even good study (when I get more time, I will).

Bottom line: no one knows what causes ALS and until it is scientifically proven as to what the cause is (it is likely multifactorial with a predisposition for the disease), we can all speculate until we're blue in the face.
 
Seeing as there is no cause found yet by research, we're all pretty much just voicing opinion. Mine falls in with trauma could speed up presentation of ALS symptoms.... think about how badly physical fatigue and stress are on a PALS once they're aware they have the disease, it would make sense that a super dose of stress/injury could jump start the first awareness that something is wrong.

Here is a quote from PubMed, original paper published in 2005: ~ for the US people reading this, keep in mind that the "football" referred to is what we call soccer ~ (and the rest of the world calls football :) ) and yes, it is the Italian soccer players who were used for the study...
The cause of amyotrophic lateral sclerosis (ALS) is still unknown. A possible relationship between ALS and sport participation has been supposed, but never definitely demonstrated. We studied a cohort of 7325 male professional football players engaged by a football team from the Italian First or Second Division in the period 1970-2001. ALS cases were identified using different concurrent sources. Standardized morbidity ratios (SMRs) were calculated. During the 137,078 person-years of follow-up, five ALS cases were identified (mean age of onset, 43.4 years). Three cases had a bulbar onset, significantly more than expected (P = 0.003). Since the number of expected cases was 0.77, the overall SMR was 6.5 [95% confidence interval (CI), 2.1-15.1]. The SMR was significantly increased for an ALS onset before 49 years, but not for older subjects. A significant increase of the SMR was found in the periods 1980-1989 and 1990-2001, whereas no ALS case was found in the 1970-1979 period. A dose-response relationship between the duration of professional football activity and the risk of ALS was found (>5 years, 15.2, 95% CI, 3.1-44.4; < or =5 years, 3.5, 95% CI, 0.4-12.7). Our findings seem to indicate that playing professional football is a strong risk factor for ALS.

The following is a list of some USA and Canadian football players who have/had ALS...
Eric Scroggins
O.J. Brigance
Glenn Montgomery
Pete Duranko
Peter Demmerle
Steve Smith
Tony Proudfoot (CFL)
Bob Waters
Orlando Thomas
Wally Hilgenberg
 
I think the relevance of brain injury to ALS needs to be further studied as well as any other avenue that research has shown there is a possible connection. However, I don't think the research available now can link brain injury to the cause of ALS that would be supported in a court of law.

I think this is an example where there needs to be a national/global registry with history of individuals to help guide research endeavors. My Dad as far as I know has not had any significant brain injury. However we have all at some point had times we injured/bumped our brain that we did not seek treatment for that may fit the category as well so how would you define the level of brain injury (axonal shearing, bleed, contusion, etc)..

I am wondering if the incidence of brain injury and any relationship to ALS has something to do with symptoms that are unnoticed and how that plays into the increased risk of sustaining an injury, i.e. falls, decreased proprioception, weakness, loss of protective responses etc. The relationship could be that early symptoms of ALS contributed to the brain injury (although that does not explain the motor vehicle accident in the OP's example.)
 
I know as little about the law as I do about medicine, but I agree with DgtoTNfan that proving in court that a car accident caused your wife to show symptoms of ALS a few months later would be just about impossible. I can't believe you could find a respected neurologist who would state under oath that trauma to the head "causes" ALS.

Finding the cause(s) of ALS will be a medical breakthrough of the first magnitude.

As to the soccer team ... doesn't that sound more like a virus or a toxin than the fact that they play a semi-violent sport? Especially since no other soccer teams have reported the same thing. Also the increased incidence among the military could be viral and/or toxin, since it occurs in vets from different eras/wars.
 
The soccer/athlete connection is a toxin/bacteria.As in my case as professional tennis player,then coach in a dusty indoor facility.I believe my environment triggered it for me.Sorry to hear of your diagnosed.GL
 
The soccer/athlete connection is a toxin/bacteria...
James, can you tell us your evidence that the connection is "toxin/bacteria" rather than head trauma for the Italian soccer players?
 
I just read both epidemiological studies dealing with Italian soccer players and the incidence of ALS (one was conducted in 2005 and the other in 2006). There were NO conclusions in either of the studies and the last thing that was more or less stated in each, is that further study is warranted. The "proposed" causes mentioned were physical fatiguing of the body, trauma, drug abuse, supplement abuse, head trauma and pesticides. Basically they mentioned everything they could think of that could POSSIBLY be equated to the "increased incidence" but had no idea why. Furthermore, the increased incidence of ALS in those players has not been proven.

A flaw in the study: the number of players investigated in each. One study had about 7,000 players. Therefore, if only one of those players developed ALS, that would be 1 in 7,000 which is much higher than the 2 in 100,000 in the general public. Therefore, no definitive conclusion can be made, for that very reason. The investigators of the study recognized that fact. The other study had about 26,000 soccer players and the increased incidence wasn't as high as the smaller study, most likely due to the larger number of players. The investigators of that study also recognized that fact.

I bet if you took any group of people . . . let's take television analysts for instance . . and surveyed just that small group of people . . . the incidence of ALS would more than likely be increased because the absolute number of people surveyed would be too low to make any definitive conclusions. It certainly wouldn't mean that television analysts are at a greater risk of developing ALS.

We have to be careful as to what we say and how we interpret things without knowing the whole story. This is precisely how information on the internet becomes so unreliable and how it incites panic. Someone will google head trauma and ALS because they might have hit their head at some point in their life (someone who is nervous that they have ALS because they simply have muscle twitches) . . . run into a post on this forum where it is stated that head trauma causes ALS . . . and all of a sudden they have convinced themselves they have ALS. We've had more than our share of these people on this forum with this exact scenario.

Am I going to sit here and say that the studies above are not intriguing and without merit? No, but I'm not going to conclude a thing about them, when the authors of the studies themselves recognized that further research needs to be done. Until anything is proven, it is all mere speculation.
 
Wright,

Very succinctly stated. Its one thing to say "I think", and quite another to say "this is why" .... Speculate as much as we like, its not as if the cause/causes are known, and just being held back from the public in some sort of dark conspiracy.

As for legal action, think how ground breaking it was for an individual to win a case against a tobacco company, and this was after it was clearly established that cigarette smoking can cause lung cancer! I'd imagine, a disease such as ALS, where there is no known cause, would have no chance in any sort of legal action, whether the claim was head injury, exposure to toxins, or any other suspected reason. It could bring ALS awareness if the proceedings made it into the national media, but what else could it accomplish?
 
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