Amyotrophic lateral sclerosis, commonly called Lou Gehrig’s disease, is a progressive neurological disease that affects nerve cells responsible for controlling voluntary muscles. Early symptoms can be subtle and vary from person to person.
Common first symptoms may include:
- Muscle weakness in one area — often starting in a hand, arm, leg, or with the muscles used for speaking/swallowing
- Dropping objects or difficulty with fine movements (buttoning clothes, writing, turning keys)
- Tripping, stumbling, or a feeling of weakness in a leg or foot
- Muscle twitching (fasciculations), especially in the arms, legs, shoulders, or tongue
- Muscle cramps or stiffness
- Slurred speech or trouble projecting the voice
- Difficulty swallowing or increased choking episodes
- Changes in coordination or balance
- Unusual fatigue with physical tasks
Early ALS can sometimes resemble other, more common conditions, so symptoms alone do not confirm the diagnosis. A neurologist typically evaluates symptoms with a physical and neurological exam and may use tests such as nerve conduction studies, electromyography (EMG), imaging, and blood tests to rule out other causes.
If someone has progressive muscle weakness, especially weakness that is spreading, persistent, or accompanied by speech/swallowing changes, it is worth seeking medical evaluation.
