Lou Gehrig’s Disease (ALS): Early Symptoms to Know

Lou Gehrig’s disease, also known as amyotrophic lateral sclerosis (ALS), is a progressive neurological disease that affects nerve cells responsible for controlling voluntary muscle movement. Over time, ALS can lead to increasing muscle weakness and difficulty with movement, speech, swallowing, and breathing.

Early symptoms can be subtle and may vary from person to person.

1. Muscle Weakness in an Arm, Leg, or Hand

One of the earliest signs may be:

Trouble gripping objects
Dropping things more often
Difficulty buttoning clothes or using keys
Weakness affecting one side of the body

2. Muscle Twitching (Fasciculations)

Small, involuntary muscle twitches may occur, often in:

Arms
Legs
Shoulders
Tongue

Muscle twitching alone is common and does not necessarily mean ALS.

3. Muscle Cramping and Stiffness

Some people experience:

Frequent cramps
Muscle tightness
Stiffness
Reduced flexibility

4. Changes in Walking and Balance

Early movement problems may include:

Tripping more often
Difficulty climbing stairs
Feeling unsteady while walking

5. Speech Changes

When ALS affects muscles involved in speech, early signs may include:

Slurred speech
A quieter voice
Difficulty pronouncing certain words

6. Trouble Swallowing

Some people develop:

Choking episodes
Difficulty swallowing food or liquids
Changes in eating habits

7. Uncontrolled Emotional Responses (in Some People)

Some individuals experience pseudobulbar affect, which can cause:

Sudden laughing or crying that does not match how they feel

What ALS Usually Does Not Affect Early On

ALS typically does not cause:

Loss of sensation (such as numbness or tingling)
Loss of vision
Loss of bladder or bowel control in most cases

However, symptoms can overlap with many other conditions, so evaluation by a healthcare professional is important.

When to Seek Medical Advice

See a doctor if you have:

Progressive muscle weakness
Persistent unexplained muscle wasting
New speech or swallowing difficulties
Increasing problems with walking or coordination

A neurologist can perform a detailed examination and tests to determine the cause.

Bottom line: Early ALS symptoms often involve gradually worsening muscle weakness, twitching, cramps, or changes in movement and speech. Many other, more common conditions can cause similar symptoms, so only a medical evaluation can determine the cause.