Dr. Aparna Gupta

“I'm not afraid of death, but I'm in no hurry to die. I have so much I want to do first”, are the famous words of a man who, against all odds pursued his passion till the end. 14 March 2018 will always be considered as one of the darkest days as the world mourns the loss of the great Dr. Stephen Hawking, who enlightened people with his theories related to, ‘exploration of general relativity and properties of the black hole’.

At the age of 21 he was diagnosed with a rare neurological disease known as Amyotrophic Lateral Sclerosis (ALS)  or Lou Gehrig’s disease and despite the challenges he faced, he lived his life with fun & vigor.

So, what is Amyotrophic Lateral Sclerosis?

Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease, which is responsible for controlling the voluntary muscle movement in the body. It is one of the rare neurological diseases and has no cure at present. It is degenerative disease i.e. the condition affected by it will get worse over a period of time and weakens the working of these neurons.

What is the cause of it?

In 90% to 95% of cases, the definitive cause of it is still not known. And, for the remaining cases, there is a possibility that this disease can occur due an inherited genetic history of certain specific genes from their parents.

How the disease affected Stephen?

The symptoms of this disease vary from person to person. Also, the disease has a tendency to spread to unaffected regions of the body with the affected regions turning worse. Due to the progressive nature of the disease, the patient eventually will not able to walk, use their hands & arms, loses his ability to speak, to swallow food or their own saliva, and lastly, it affects the ability to cough & breathe resulting in the death of the patient.

In most of the cases, people who are diagnosed with ALS live up to 2-5 years. However, Hawking was a rare case who survived for over 50 years, since he was diagnosed when he was 21. And, in spite of his disease, he came up with highly elaborate researches such as that of the black hole theory.

How did he survive for so long?

When a patient suffers from ALS it is possible he or she can die due to respiratory failure, or deterioration of swallowing muscles which leads to dehydration and malnutrition. The case of Hawking is still a mystery for both doctors and scientists alike. As, in all ALS cases, the symptoms of cognitive dysfunction or memory dysfunction are common but were proven wrong in Hawking’s case. As per Hawking’s biography ‘A Brief History of Time’, his grasping, and learning ability improved only after his disease.

Due to the progression of his disease, he was paralyzed and confined to a wheelchair and was not able to perform day to day activities such as bathing, eating, and even talking. He was only able to move a few fingers. In order to overcome his difficulties, he started using a speech synthesizer that gave him a computerized voice. Also, after reading his case many doctors claimed that the disease progressed slower than it usually does in his case.

Common signs of this disease

• Twitching in muscles of leg, arms and shoulder
• Frequent muscle cramps
• Tightness in muscles
• Muscle weakness in arms and legs
• Slurred speech
• Difficulty in swallowing and chewing

Although the above symptoms can indicate other health ailments in case of continuous occurrence one should consult a doctor immediately. In case of any concern, do consult an expert and get answers. 

Getting hallucinations is a mental condition where a person sees, feels, hears, and tastes things that actually don't exist beyond one's heightened imagination or delusion. It involves the experience of perceiving something not present.  Hallucinations can be pleasing or frightening. However, there is almost always an identifiable cause behind it. 

They can be triggered by:

1. Taking hallucinogenic or psychotropic substances
2. Mental conditions like dementia and schizophrenia
3. Neurological conditions like Alzheimer's disease or Parkinson's disease
4. Macular degeneration, leading to loss of vision
5. Migraines and brain tumor can also lead to such delusions

Some of the signs of hallucinations:

1. Hearing voices: The medical term for hearing voices is called an 'auditory hallucination'. A person may sense sounds or noises coming from inside or outside of their mind. The noise might be random or disrupting. One might also feel the voices talking to each other or trying to tell them something. Most of the times, these voices come from inside the person's mind; or in some cases, one's heightened perception may make a normal noise delusional.
2. Seeing things: This is also called visual hallucinations. For instance, one may see unnatural things like a floating chair in thin air. It all depends on a person's perception. Sometimes these hallucinations appear as bright flashy spots or rays of light.
3. False sense of taste and smell: Technically, these are known as gustatory and olfactory hallucinations respectively. One may feel a kind of odor coming from one's body or surrounding; or a person might feel that something he/she is drinking or eating has an odd taste. This is again too much thinking, causing delusional sensory activities. 
4. Tactile hallucinations: This is when a person feels things that don't exist. One may feel that he/she is being touched or tickled even when no one else is around or that insects are crawling beneath the skin. One may experience strange sensations, which are not a part of a reality.