Can anesthesia and surgery trigger ALS?

In fact, some ALS patients report that the first symptoms of their disease became apparent immediately after surgery, usually involving anesthesia. This leads those affected to suspect that the physical stress of surgery or the medications used may have contributed to or triggered ALS. While patients’ concerns are understandable, they are not supported by medical or scientific evidence.

ALS is a chronic disease of the motor nervous system, preceded (until the onset of the first symptoms) by a disease process lasting several years. All scientific data indicate that microscopic deposits of TDP-43 (and other proteins) are already present several years before the onset of outward symptoms, and that the degeneration of motor neurons has already begun. The brain and spinal cord are highly adaptable and can compensate for the loss of function and degeneration of motor neurons over extended periods of time, so that no symptoms appear initially. It is only when the nervous system is subjected to further stress—such as that associated with anesthesia and surgery—that the existing compensatory mechanisms become overwhelmed. As a result, the first symptoms begin to appear. Anesthesia or surgery represents the proverbial straw that “breaks the camel’s back.” However, it must be ruled out that surgeries are directly responsible for triggering ALS.