Lou Gehrig’s disease, also called amyotrophic lateral sclerosis (ALS), is a progressive disease affecting the nerve cells that control voluntary muscles. Early symptoms can be subtle and are often caused by many other, much more common conditions.
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Mayo Clinic
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Early symptoms can include
Gradually worsening muscle weakness — often beginning in one hand, arm, foot, or leg.
Dropping objects or hand clumsiness — difficulty buttoning clothes, writing, opening containers, etc.
Tripping or difficulty walking — including weakness around the ankle or foot.
Muscle twitching (fasciculations) — particularly when accompanied by weakness.
Muscle cramps or stiffness.
Slurred or slowed speech.
Difficulty chewing or swallowing.
Uncontrollable laughing or crying in some people.
Changes in thinking or behavior can occur in some forms of ALS.
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Mayo Clinic
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One important distinction
A muscle twitch by itself does not mean ALS. Likewise, occasional cramps, numbness, fatigue, or clumsiness are much more commonly caused by other conditions.
What particularly raises concern is progressive, usually painless muscle weakness that continues to worsen or spreads.
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ALS Association
There is no single test that confirms ALS. A neurologist typically uses the history and neurological examination along with tests such as EMG/nerve-conduction studies and imaging or laboratory tests to rule out other conditions.
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NINDS
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If someone is developing progressively worsening weakness, repeated falls, unexplained speech changes, or difficulty swallowing, they should arrange a medical/neurological assessment rather than trying to diagnose ALS from symptoms online.
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