Amyotrophic Lateral Sclerosis (ALS) also known as Lou Gehrig’s disease

Amyotrophic lateral sclerosis is a disease of the nerve cells in the brain, brain stem and spinal cord that control voluntary muscle movement.

Amyotrophic lateral sclerosis (ALS) is a disease of the nerve cells in the brain, brain stem and spinal cord that control voluntary muscle movement.

In ALS, motor nerve cells (neurons) waste away or die, and can no longer send messages to muscles. This eventually leads to muscle weakening, twitching and an inability to move the arms, legs and body. The condition slowly gets worse over time. When the muscles in the chest area stop working, it becomes hard or impossible to breathe.

There are 2 different types of ALS.

Sporadic ALS (SALS), the most common form, occurs in people without a family history of ALS.
Familial ALS (FALS) occurs in 5 to 10 percent of cases and there is usually a clear family history of the disease.

ALS Symptoms

Symptoms usually do not develop until after age 50 but they can start in younger people. ALS symptoms usually start with painless weakness developing in a hand or foot and can be mistaken for more common problems, such as carpal tunnel syndrome or a pinched nerve. The muscle weakness slowly gets worse. Other symptoms and signs include:

Muscle stiffness and wasting
Muscle cramps and twitching
Slurred speech or swallowing problems
Behavior changes which can interfere with decision-making
Becoming more emotional - crying and laughing more easily

ALS mostly affects upper and lower motor neurons, which are the nerve cells that control movements of the arms, legs, face, diaphragm, throat and tongue.

Automatic movements (such as the gut moving food and the heart beating), sensation and eye movements are generally not affected. ALS usually has minimal impact on a person’s intellect and bowel/bladder control. ALS is usually not painful.

ALS Causes

The cause of ALS is unknown and most scientists believe that a complex interaction of genetics and environmental factors cause sporadic ALS. There is no evidence that any particular toxin, occupational exposure or nutritional deficiency causes ALS.

Who is at Risk?

In the United States, there are approximately 5,000 people diagnosed each year with ALS and 30,000 people with the disease at any given time.

Most people afflicted with ALS are between the ages of 40 and 70, but it can affect younger adults and the elderly. Men are affected slightly more frequently than women.

Having a family member who has a hereditary form of the disease is a risk factor of ALS. Other risk factors include military service.

The average life expectancy from the beginning of symptoms is around 3 years, but about 25 percent of patients live 5 years and 10 percent will survive 10 or more years.

ALS Diagnosis

There is no single test used to establish a diagnosis of ALS. Your physician will perform a physical exam and ask about your medical history and symptoms.

You may be referred to a neurologist. He or she will perform a neurological exam to test muscle strength, reflexes, sensation, walking, speech, swallowing and other functions. Certain abnormalities are frequently found in patients with ALS:

Brisk reflexes
Stiff arms and legs
Uninhibited laughing or crying
Wasting of muscles
Weakness
Muscle twitching
Cramps

Other tests include:

Electromyography (EMG) involves a needle being placed into a muscle to evaluate its function.
In nerve conduction studies, integrity of nerves is examined through electrical stimulation.
Blood is drawn and evaluated to eliminate other diseases which mimic ALS.
Magnetic Resonance Imaging (MRI) images the brain or spinal cord.

ALS Treatment

There is no known cure for ALS. Riluzole is the only FDA-approved medication for ALS, but its effect is quite modest. It slows the progression of the disease slightly and is generally safe with tolerable side effects.

Other medications can be prescribed, and suggested home remedies can minimize ALS symptoms such as muscle cramps, spasticity (stiffness), excess saliva, behavior changes, depression, constipation, insomnia, anxiety and weight loss.

Wake Forest Baptist ALS Clinic

The ALS Clinic aims to extend longevity, maximize independence and improve quality of life by offering specialized services to patients diagnosed with ALS. Established in March 1998, the ALS Clinic is an ALS Association certified Center of Excellence - one of only 33 such centers in the country. Patients receive care from a multidisciplinary team of ALS specialists which research has shown results in a longer lifespan and a higher quality of life.

Care and Treatment

Providers

Locations

ALS Resources

The following organizations are good resources for information on amyotrophic lateral sclerosis (ALS).

ALS Association (ALSA)

Northeast ALS Consortium

Robert Packard Center for ALS Research

Muscular Dystrophy Association's ALS Division

ALSA - North Carolina Chapter

National ALS Registry

Insurance

Insurance Accepted

This chart is a list of the most common health insurance plans we accept. This list is subject to change. Please check your individual plan to confirm their participation and the coverage allowed.

Due to the different physician groups and hospitals within the Wake Forest Baptist system, physician services and hospital services are billed separately. Please remember that health insurance coverage varies, so some services may not be covered.

If you don’t see your plan or you have questions, please call our Customer Service Center at 877-938-7497. We will do our best to work with you and your plan.

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital (Includes Davie)
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC -Not Contracted, very low to no volume for facility and/or CHC

Wake Forest Baptist Health Managed Care/MA Contracts - April 2024

AETNA CONNECTED NC ACA/Exchange: Accepted at all locations

AETNA NC PREFERRED+: Accepted at all locations

AETNA (PPO & HMO): Accepted at all locations

AETNA MEDICARE: Accepted at all locations

AETNA WHOLE HEALTH: Accepted at all locations

ALIGNMENT HEALTHCARE MEDICARE ADVANTAGE: Accepted at all locations

AMBETTER OF NC: Accepted at all locations

AMERIHEALTH CARITAS NEXT ACA/Exchange: Accepted at all locations

BCBSNC (PPO & HMO): Accepted at all locations

BCBS HIGH PERFORMANCE (NATIONAL NETWORK): Accepted at all locations

BLUE LOCAL WITH ATRIUM HEALTH: Accepted at all locations

BLUE MEDICARE: Accepted at all locations

BLUE VALUE: Accepted at all locations

CAROLINA BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH and CHC (not applicable to services provided at LMC, Wilkes and High Point)

CIGNA: Accepted at all locations

CIGNA BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH and High Point (not applicable to services provided at LMC, CHC and Wilkes)

CIGNA HEALTHSPRING MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, LMC, CHC and High Point (not applicable to services provided at Wilkes)

CIGNA LIFESOURCE (TRANSPLANTS): Accepted at WFUHS and NCBH (not applicable to services provided at LMC, CHC, Wilkes and High Point)

CRESCENT PPO (ASHEVILLE): Accepted at WFUHS and NCBH (not contracted, very low to no volume for LMC, CHC, Wilkes and High Point)

DEVOTED HEALTH (MEDICARE ADVANTAGE): Accepted at all locations

DIRECT NET: Accepted at WFUHS, NCBH, LMC, Wilkes and High Point (not contracted, very low to no volume for CHC)

FIRST HEALTH NETWORK: Accepted at NCBH, LMC, Wilkes and High Point (not contracted, very low to no volume for WFUHS and CHC)

FIRSTCAROLINACARE (PINEHURST, NC): Accepted at NCBH (not contracted, very low to no volume for WFUHS, LMC, CHC, Wilkes and High Point)

GATEWAY HEALTH ALLIANCE (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for LMC, CHC, Wilkes and High Point)

HEALTHGRAM (formerly PRIMARY PHYSICIAN CARE): Accepted at WFUHS, NCBH and LMC (not contracted, very low to no volume for CHC, Wilkes and High Point)

HEALTHTEAM ADVANTAGE: Accepted at all locations

HUMANA CHOICECARE: Accepted at all locations

HUMANA MEDICARE ADVANTAGE: Accepted at all locations

LIBERTY ADVANTAGE (MEDICARE ADVANTAGE): Accepted at WFUHS and NCBH (not applicable to services provided at LMC, CHC, Wilkes and High Point)

MAGELLAN (BEHAVIORAL HEALTH): Accepted at WFUHS, NCBH and CHC (not applicable to services provided at LMC, Wilkes and High Point)

MEDCOST: Accepted at all locations

MEDCOST ULTRA: Accepted at WFUHS, NCBH, LMC, Wilkes and High Point (not applicable at CHC)

PHCS/MULTIPLAN: Accepted at NCBH, CHC, LMC and High Point (not contracted, very low to no volume for WFUHS and Wilkes)

OPTUMHEALTH (TRANSPLANTS - APPLICABLE TO NCBH/WFUHS ONLY): Accepted at WFUHS and NCBH (not applicable to services provided at LMC, CHC, Wilkes and High Point)

PREFERRED CARE OF VA INC: Accepted at WFUHS and NCBH (not contracted, very low to no volume for LMC, CHC, Wilkes and High Point)

SOUTHERN HEALTH SVCS (COVENTRY-PPO ONLY): Accepted at WFUHS, NCBH and CHC (not contracted, very low to no volume for LMC, Wilkes and High Point)

TWIN COUNTY (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for LMC, CHC, Wilkes and High Point)

UNITED BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH, CHC and High Point (not applicable to services provided at LMC and Wilkes)

UNITED BEHAVIORAL HEALTH INTENSIVE OUTPATIENT PROGRAM (WFUHS ONLY): Accepted at WFUHS (not applicable for services provided at NCBH, LMC, CHC, Wilkes and High Point)

UNITED HEALTHCARE: Accepted at all locations

UNITED HEALTHCARE ESSENTIALS ACA/EXCHANGE: Accepted at all locations

UNITED HEALTHCARE MEDICARE: Accepted at all locations

VA CCN: Accepted at all locations

WELLCARE (MEDICARE ADVANTAGE): Accepted at all locations

LMC ONLY: Contracts specific to support Lexington employer groups, low volume
NATIONAL PROVIDER NETWORK/MEDICAL RESOURCES

CHC ONLY: Contracts specific to support CHC
TRICARE

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital (Includes Davie)
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC - Not Contracted, very low to no volume for facility and/or CHC

Referring Physicians

At Atrium Health Wake Forest Baptist we understand the importance of referrals. Our Physician Liaisons partner with referring physicians in our community and beyond to provide information on our physicians and clinical services. Full list of new physicians.

Contact the Physician Liaisons

Education and Research

The Neuromuscular Medicine Fellowship at Wake Forest School of Medicine is a one year training program with 2 fellows selected each year. Training comprises instruction in and exposure to NM disorders, NCS/EMG and NM ultrasound, neuropathology, and specific procedures including chemodenervation, UHC needle muscle biopsy, IENF skin biopsy, autonomic testing, and single fiber EMG.

Research is another significant focus of our neuromuscular specialists. We have competitive extramural support for training and clinical investigation. We participate actively in multi-center clinical trials and have a large unrestricted gift to be used for the study of motor neuron disease. Current studies involve ALS, Charcot-Marie-Tooth, muscular dystrophies, Huntington’s disease, chemodenervation agents, compression neuropathies and voice disorders.