Symptoms of ALS

Symptoms of ALS generally start insidiously, slowly making themselves apparent. In general, amyotrophic lateral sclerosis is a consistently progressive disorder, meaning that it tends to progress with more and more ALS symptoms over time, getting worse as time goes by. For this reason, the initial onset of ALS and the initial symptoms of ALS may be subtle and may go overlooked for some period of time.

These initial symptoms can present quite differently in different people, but they all fall into the same general category, impairment in muscle function which leads to symptoms of muscle dysfunction. There does not appear to be a consistent pattern or sequence to the new symptom evolution. Some patients may present with extremity symptoms (arms or legs) first while another presents more with speech or swallowing problems. The rate of progression of the disease can vary somewhat from patient to patient as well.

Some Common Initial ALS Symptoms:

• Dysfunction of muscle, leading to weakness - this can affect almost any muscles and can cause symptoms related to impairment of use of the extremities, weakness of the hands, arms less or feet, dysfunction of speech, swallowing or breathing.
• Twitching and/or cramping of muscles, particularly those in the feet or hands. This twitching is called fasciculation.
• Shortness of breath and other difficulty with breathing or swallowing often present in later stages of the disease.

In essence, all of these symptoms occur because of damage to the nerve cells that tell the muscles to contract. As the muscles loose this "wiring" they become weaker and weaker, explaining the typical symptoms of muscle weakness. While the initial symptoms may be quite subtle or vague, as they progress they become profound, eventually resulting in complete muscle paralysis. In the later stages of the disease, when the muscles that are important for speech, swallowing and breathing become significantly affected, patients will require breathing support to survive. Eventually, death typically results from respiratory failure and/or lung infections associated with the disease and its care.

Again, how symptoms of ALS present in any one patient can vary somewhat. While they are all symptoms related to weakness of muscles, which muscles and how they become noticed can vary. Whereas one patient may begin to notice problems with tripping because of subtle weakness of the muscles of the legs and feet, another may notice problems with grip strength and dropping things.

Any new symptoms of weakness or loss of muscle function should be worked up by an appropriate physician as they can represent ALS as well as a number of other conditions affecting the nervous system or musculoskeletal system.