Lou Gehrig’s syndrome is another name for Amyotrophic lateral sclerosis (ALS). It is a progressive disease that affects the nerve cells that control voluntary muscles.
Early symptoms can be subtle and vary depending on which nerves are affected first.
Common early symptoms
- Muscle weakness
- Difficulty lifting objects
- Trouble climbing stairs
- One hand or foot becoming noticeably weaker
- Muscle twitching (fasciculations)
- Often in the arms, legs, shoulders, or tongue
- Twitching alone is common and usually does not mean ALS
- Muscle cramps
- Painful cramps that occur more often than usual
- Clumsiness
- Frequent tripping
- Dropping objects
- Difficulty with buttons or writing
- Slurred speech
- Speech may become slower or less clear
- Difficulty swallowing
- Choking or coughing while eating or drinking
- Weakness in the feet (“foot drop”)
- The front of the foot drags while walking
- Fatigue
- Muscles tire more easily during everyday activities
What ALS usually does not cause early on
In most people, ALS does not initially affect:
- Sensation (touch, pain, or temperature)
- Bladder or bowel control
- Vision
- Hearing
When to seek medical evaluation
See a healthcare professional if you have:
- Progressive muscle weakness
- Persistent difficulty speaking or swallowing
- Repeated falls or worsening coordination
- Muscle weakness that continues to worsen over weeks or months
These symptoms do not necessarily mean ALS. Many more common conditions—including nerve compression, vitamin deficiencies, thyroid disorders, and other neurological diseases—can cause similar symptoms. A neurologist can perform the appropriate examination and tests to determine the cause.
Bottom line
ALS is a rare disease. While early symptoms often involve progressive muscle weakness, twitching, cramps, and difficulty with movement or speech, these symptoms are much more commonly caused by conditions other than ALS. If they are persistent or worsening, it’s important to get a medical evaluation rather than assume the cause.
