Slightly O/T: Did Lou Gehrig really have Lou Gehrig's Disease?

[scooter729]

Interesting article as to whether Gehrig's illness was actually caused by traumatic incidents / concussions, and not a case of ALS.

http://www.nytimes.com/2010/08/18/sports/18gehrig.html?_r=1

And I will beat Rob to the punch and wish condolences to the entire Gehrig family.

[BillyCoxDodgers3B]

And I will beat Rob to the punch and wish condolences to the entire Gehrig family.

Are there even any Gehrig blood relatives left?

The medical community may have to rename the disease if this is actually the case. "Joe Rogalski's Disease" doesn't quite have the same effect, however (Rogalski was another prewar MLB veteran to succumb to ALS).

[David Atkatz]

There are no blood relatives. Gehrig was the only child of his parents surviving into adulthood, and he had no children of his own.

The study seems to focus on soldiers who suffered significant head trauma. I don't think it's easy to relate that to sports injuries. If Gehrig were not suffering from ALS, I think that statistically a number of other ballplayers would have been thus "diagnosed." That is not the case, which leads me to believe the disease is properly named.

[ElCabron]

Real Sports with Bryant Gumbel just aired a story about this and it sounds like he did indeed have ALS, but we now may know how he got it: head trauma. He was knocked out 6 times in his career. A key to preventing long-term damage to the brain post-concussion is rest immediately following the injury. As we all know, in every case where Gehrig was knocked unconscious he was in the lineup the very next day. Sadly, the streak may have been a factor that lead to his early death.

-Ryan

[alanu]

The Real Sports is a real eye opener. It shows that not only football players and boxers have a significant higher incident of ALS, but also soccer players.

[autograf]

Great story on a great show.....saw that last night and the study results are really interesting. Hopefully from the findings, they can work towards some remedy or aid. The soccer connection was wild. Soccer players may reconsider those headers a little more in the future....

[drdduet]

Given his preserved mental function I would say he had ALS. ALS is a motor neuron disease. Chronic head trauma will affect cerebral function at a high level, where ALS will not.

From all the information I've seen Lou Gehrig did have ALS. There is a straight forward distinction between the two entities as ALS spares cognitive, oculomotor, sensory, and autonomic functions and chronic concussive syndrome does not.

Mohammed Ali has chronic concussive syndrome, Stephen Hawking has ALS. The two are quite different in presentation.

[Exhibitman]

If you've ever spoken with or heard a speech by an ex-boxer who has taken a few too many shots to the head you can tell the difference in an instant between him and Gehrig.

[ElCabron]

Dr. D.,

Are you saying there is no causal link between head trauma and ALS? That seemed to be the main point of the story and it sounded like groundbreaking information that could go along way in prevention (or perhaps someday cure?) of ALS.

It's clear there's a difference between ALS and chronic concussive syndrome. But the Real Sports segment never said Gehrig didn't have ALS, only that he might have gotten it from head trauma.

How would you explain extremely high (statistically improbable) rate of ALS in ex-athletes in sports where head injury is common? Particularly boxing, football and soccer. These athletes are so young and suffer so much, it was encouraging to see that some of that might be preventable in the future. It's disheartening to hear you say otherwise, but if that's how it is, then that's how it is.

Interested to hear your perspective.

-Ryan

[drdduet]

Hi Ryan,

I was strictly commenting on the original thread starting post. I did not see the Real Sports episode brought up so I cannot comment on it. I would find it highly unlikely that repeated head trauma have a direct causative effect for the development of ALS. There is no solid medical evidence that I am aware of to suggest otherwise, and it wouldn't explain why individuals without a history of head trauma develop it.

My interpretation of the article is that it is suggesting that there were many people--prior to the advent of medical technology--who were misdiagnosed with ALS, when in fact they had chronic concussive syndrome. This phenomena does occur quite frequently in medicine, especially when a high profile individual gets a little known or rare diagnosis--mainly because of the publicity the rare disease gets, so docs and the general public become more aware.

I'll look into viewing that Real Sports episode and post here after doing so.

Thanks

[autograf]

DRD.....

The Real Sports piece was looking at primarily NFL & CFL football players along with boxers but also threw in some alarmingly high rates for soccer players from Europe. The average occurrence of ALS in 'normal' population was 1/100K. Based on the stats, there should be few to any ALS cases in the NFL current or previous players nor for boxers. The actual rates, however, were significantly higher with multiple cases in each type of sport. The results were to be published I think yesterday in a Neurological medical journal (not sure which one). The two people doing the study had actual brains from football players and boxers and spinal cords as well and there were indicators in both the brain and the spinal columns that repetitive concussions caused ALS indicators in both the brains and the spinal cords. Not a doctor here, nor did I sleep in a Holiday Inn Express last night but the piece seemed to have merit. Guess anyone can do any type of study out there and fine someone to validate it but it sure seemed like these folks had their ducks in a row.

p.s. I'm not sure if it was for effect or another indicator but almost all the people previewed with ALS that had been in NFL or CFL were defensive players and backs whose primary job it is to wind up and hit people. Found it odd that not a lot of offensive 'skill' players were among the group..........