ALS Home > ALS Symptoms

The initial symptoms of ALS often go unnoticed because the early phases of the disease are so subtle. But as damage to the nerve cells progresses, the person can experience exaggerated reflexes and tight, stiff muscles (due to upper motor neuron damage) and muscle weakness and twitches (due to lower motor neuron damage). Regardless of where the symptoms first appear, as the disease progresses, muscle weakness and atrophy will spread to other parts of the body and eventually lead to a complete loss of function.

Early Signs and Symptoms of ALS

The early symptoms of ALS (amyotrophic lateral sclerosis) are frequently overlooked because the disease is so subtle in its early stages. When present, the earliest ALS symptoms may include:
 
  • Muscle stiffness, twitching, or cramping
  • Weakness affecting an arm or leg
  • Slurred and nasal-sounding speech
  • Difficulty chewing or swallowing.
     
These general symptoms then develop into more obvious weakness or atrophy (loss of muscle tissue) that may cause a doctor to suspect ALS.
 
The body parts that early ALS affects will depend on which muscles are damaged first. In some cases, one of the legs is affected and the person experiences awkwardness when walking or running -- or he or she begins to trip or stumble more often. In other cases, the person experiences problems with a hand or arm and has difficulty with simple tasks requiring manual dexterity, such as buttoning a shirt, writing, or turning a key in a lock. Other people may experience speech problems as their first symptom of ALS.
 

Common ALS Symptoms

Regardless of where the ALS symptoms first appear, muscle weakness and atrophy will spread to other parts of the body as the disease progresses.
 
Eventually, people who have ALS will experience increased problems with:
 
  • Moving
  • Swallowing (dysphagia)
  • Speaking or forming words (dysarthria).
     
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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