Correlation between surgery and ALS

This fall I'm having shoulder replacement surgery(I'm 68 yrs old) . My father died of ALS at age 55yrs.  I have read about a correlation between surgery and the onset of ALS. Needless to say, it frightens me, should I be worried?

Jim Starrs

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

As you may know, the exact cause for ALS is unknown, and it most often emerges nonspecifically, without associated events, but sometimes it does emerge in the background of other occurrences such as infections, surgeries, or other medical issues. The temporal association with these events has been documented in several cases, but it is not thought that surgery or infection per se causes or brings out ALS. To put it plainly, if you are going to develop ALS, then it will develop regardless of whether or not a surgery occurs. Surgery might unmask the symptoms, or during recovery from your surgery, which may take some toll on you, you may start to notice weakness that you had notice during more vigorous day to day activity, but surgery itself will not cause ALS.

Familial ALS is rare, though it is true that ALS is more likely to occur in those with a family member with ALS. Discussion of your concerns with a physician is recommended; if you are interested in pre-clinical counseling, genetic counseling and evaluation by a neurologist may be of benefit to you. If you are having any symptoms that could be consistent with ALS, such as muscle weakness, muscle twitching, difficulty swallowing or talking or slurred speech, or breathing trouble, then evaluation for ALS is indicated, particularly if you are planned for surgery, so that appropriate measures can be instituted during surgery, particularly in relation to respiration (breathing management during the surgery and afterwards).

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.