Lou Gehrig’s Disease (ALS): Early Symptoms to Know
Lou Gehrig’s disease, medically called amyotrophic lateral sclerosis (ALS), is a progressive neurological disease that damages motor neurons—the nerve cells responsible for voluntary muscle movement. Early symptoms can be subtle and vary considerably from person to person.
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Common early symptoms
Gradually worsening muscle weakness, often beginning in one hand, arm, leg, or foot.
Dropping objects or losing hand dexterity, such as difficulty buttoning clothes or using utensils.
Tripping, stumbling, or difficulty walking, sometimes because a foot begins to drag.
Muscle twitching (fasciculations) or persistent muscle cramps.
Muscle stiffness or tightness (spasticity).
Slurred, slowed, or unusually nasal speech.
Difficulty chewing or swallowing in cases that begin in the muscles controlling the mouth and throat.
Muscle wasting, as affected muscles become smaller and weaker.
Uncontrollable laughing or crying (pseudobulbar affect) in some people.
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An important distinction
Having muscle twitching, cramps, weakness, or difficulty walking does not mean you have ALS. Many much more common and treatable conditions can cause similar symptoms. ALS is diagnosed through a neurological examination and appropriate testing while doctors rule out other possible causes; there is no single test that confirms ALS.
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What makes ALS particularly concerning is progressive, usually painless muscle weakness that continues to spread or worsen rather than a symptom that comes and goes.
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If you or someone you know has new, progressively worsening weakness, unexplained muscle wasting, or increasing difficulty speaking or swallowing, arrange a medical evaluation, preferably with a neurologist.
Bottom line: Early ALS often starts with a seemingly small loss of strength or coordination—such as repeatedly dropping things or tripping. But these symptoms have many possible causes, so they should be evaluated rather than assumed to be ALS.
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