The earliest signs of ALS usually include muscle weakness or stiffness (spasticity). ALS typically affects all muscles under voluntary control, and the person ultimately loses their strength and ability to eat, speak, grasp things, move, and even breathe. They find it difficult to perform routine tasks such as feeding themselves or getting dressed.
Many people with ALS notice the first signs of the disease in the hand or arm as they find it difficult to perform simple tasks such as turning a key in a lock, buttoning a shirt, combing their hair, or writing.
Some report initial symptoms in one of the legs causing difficulty or awkwardness when walking or running. They may also report that they are tripping or stumbling more often than before. If the initial symptoms affect the arms or the legs, it is called a ‘limb onset’ ALS.
Few people notice their first symptoms as difficulty in speech or swallowing, but these may rarely be the first signs of ALS. This is termed as ‘bulbar onset’ ALS.
Some of the early symptoms of ALS are:
- Muscle twitches or fasciculations in the arm, leg, shoulder, or tongue
- Muscle tightness or stiffness (spasticity)
- Muscle cramps
- A weakness of muscles affecting an arm, a leg, neck, or diaphragm (the muscular partition separating the chest from the abdomen).
- Slurred speech
- Nasal voice
- Difficulty in chewing or swallowing.
Whatever may be the initial symptom, most people with ALS eventually die from respiratory failure, usually within two to five years from when the symptoms first appear. About 10% of people with ALS, however, survive for 10 years or more after diagnosis.
What does ALS do to your body?
ALS belongs to a group of disorders known as motor neuron diseases (MND). The disease causes gradual damage to the nerve cells (motor neurons).
Motor neurons extend from the brain to the spinal cord and to muscles throughout the body. They are responsible for carrying messages between the brain, spinal cord, and the voluntary muscles that help you do various tasks such as grasping objects, talking, eating, dressing up, and moving around. In ALS, the death of these neurons stops the transfer of messages from the brain and spinal cord to the muscles.
The disease has a progressive and fatal course. In absence of the control from the nerves, the muscles stay unused and gradually weaken, twitch (fasciculations), and waste away (atrophy). It ultimately causes the brain to lose its ability to initiate and control voluntary movements. There is a progressive decline in the ability to talk, write, pick up or hold things, swallow, and breathe.
There is no cure for ALS. People with this disease have a shortened life expectancy and may die within a few years of diagnosis. ALS most commonly affects white people, males, and people over age 60.
How is ALS diagnosed?
The diagnosis of ALS is based on a detailed history of the symptoms and signs observed by a doctor during a physical examination, along with various tests to rule out other mimicking diseases.
Your doctor may request certain tests which include:
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MS (Multiple Sclerosis) vs. ALS (Amyotrophic Lateral Sclerosis)ALS (amyotrophic lateral sclerosis, Lou Gehrig's disease) and MS (multiple sclerosis) are both diseases of the nervous system (neurodegenerative). ALS is a disease in which the nerve cells in the body are attacked by the immune system, although it's not considered an autoimmune disease by some scientists. MS is an autoimmune disease in which the insulated covering of the nerves (myelin sheath) in the CNS (central nervous system) degenerate, or deteriorate.
Scientists don't know the exact cause of either problem. However, they have discovered that mutations in the gene that produces the SOD1 enzyme were associated with some cases of familial ALS. Scientists also theorize that multiple sclerosis may be caused by infection or vitamin D deficiency. ALS occurs between 50-70 years of age (the average age of occurrence ALS is 55), and mostly affects men. While MS occurs between 20-60 years of age, and mostly affects women. About 30,000 people in the US have ALS, and an average of 5,000 new diagnoses per year (that's about 15 new cases per week). Worldwide, MS affects more than 2.3 million people, with about 10,000 new cases diagnosed each year (that's about 200 new diagnoses per week).
Some of the signs and symptoms of both diseases include muscle weakness, muscle spasms, problems walking, fatigue, slurred speech, and problems swallowing. ALS signs and symptoms that are different from MS include problems holding the head upright, clumsiness, muscle cramps and twitches, problems holding objects, and uncontrollable periods of laughing or crying. MS signs and symptoms that are different from ALS include vision problems, vertigo and balance problems, sexual problems, memory problems, depression, mood swings, and digestive problems.
There is no cure for either disease, however the prognosis and life expectancy are different. Multiple sclerosis is not a fatal condition, while ALS progresses rapidly and leads to death.
Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
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