Common early symptoms include:
- Muscle weakness in an arm, leg, hand, or foot
- Frequent tripping or difficulty walking
- Weak grip, making it harder to hold objects or button clothes
- Muscle twitching (fasciculations), often in the arms, shoulders, or tongue
- Muscle cramps or stiffness
- Slurred speech or changes in voice
- Difficulty swallowing in some people
- Unexplained weight loss due to muscle wasting
- Fatigue, especially during physical activity
As the disease progresses, muscle weakness spreads to other parts of the body, making movement, speaking, swallowing, and eventually breathing more difficult. Thinking, memory, sensation (touch, pain), and bladder and bowel function are often preserved, although some people experience changes in thinking or behavior.
When to seek medical evaluation
Many of these symptoms are much more commonly caused by other, often treatable conditions, such as nerve compression, vitamin deficiencies, thyroid disorders, or other neurological diseases. However, if you have persistent, progressive muscle weakness, repeated falls, or difficulty speaking or swallowing, it’s important to see a healthcare professional promptly.
Diagnosing ALS usually involves:
- A neurological examination
- Electromyography (EMG) and nerve conduction studies
- Blood tests and sometimes imaging (such as MRI) to rule out other conditions
Early evaluation is important because several conditions that mimic ALS can be treated, and specialist care can help manage symptoms if ALS is diagnosed.
