The first signs of amyotrophic lateral sclerosis (ALS) are often muscle weakness and twitches leading stumbling and falls. Individuals may also have trouble speaking and eating.

Amyotrophic lateral sclerosis (ALS) is a rare progressive disease affecting about 31,000 people in the United States. Known also as Lou Gehrig’s disease, it affects the nerve cells that control voluntary movements.

However, ALS can be difficult to diagnose at times. Early signs are often overlooked because people often write them off as clumsiness or the result of being tired.

This article helps you be more aware of the early warning signs of ALS, allowing you to get a proper diagnosis earlier to better prepare for managing the condition.

There are two main types of ALS, and each type can bring a different set of symptoms at the time you receive your ALS diagnosis. Both mean a progressive loss of motor neurons, which means that a person with ALS will start to lose control of movements in their limbs, mouth, or throat.

Early symptoms of ALS include:

  • Muscle twitches and cramps: These often impact the feet and hands, but they may include the tongue, too. These can occur whether you are awake or asleep, and they can disturb sleep.
  • Muscle weakness: You may notice that the muscles in one hand and then the other are becoming weaker. It may be more difficult to button a shirt, or you may find that you drop things more often. Similarly, one leg and then the other may become weaker resulting in more trips and stumbles.
  • Muscle stiffness: Muscle tone can increase until the increased stiffness impedes your typical movement.
  • Slurred speech: Weakening facial muscles can make the voice appear more nasally and cause projection to be harder.
  • Difficulty chewing or swallowing: This is the result of weakening facial and tongue muscles.

More about ALS

You can read more here about the causes, complications, and treatment options for ALS. Additionally, you can also delve into how ALS is different from multiple sclerosis here.

Was this helpful?

Although ALS symptoms can begin at any age, the likelihood increases with age, You’re most likely to develop ALS between ages 55 and 75.

Other factors also appear to play a role in ALS development, including gender.

Older research indicated that more men than women are being diagnosed at younger ages. This means that symptoms are more likely to show up earlier in males for reasons that are not fully understood but may be related to exposures to different environmental toxins and different biological responses.

That same research also found that men are more likely to have symptoms first displayed in the spinal region, while women are more likely to show their first symptoms in the bulbar region. This means that men are more likely to experience problems in the arms and legs, while women may be more likely to struggle with speech or swallowing.

People of all races and ethnicities can develop ALS. But research also indicates that there’s a higher prevalence of ALS diagnoses in white and non-Hispanic people.

Language Matters

In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes, and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.

Was this helpful?

Every individual’s ALS progression will be different.

From the early symptoms, ALS will ultimately advance until an individual becomes unable to speak freely, walk, and use their hands. Eventually, breathing will even become difficult as the breathing-related muscles weaken.

While some may live as long as 10 years before succumbing to respiratory failure, most people with ALS live 2 to 5 years after symptoms begin to develop. However, those who are younger when signs first appear tend to live slightly longer.

Approximately 5% to 10% of ALS cases are passed down within families, or are inherited. People with this type of ALS are more likely to only live 1 to 2 years after symptoms first appear.

Early diagnosis can allow time to learn more about ALS, access therapies, and make important end-of-life decisions before an individual becomes weaker.

Your doctor may recommend:

  • talking with a specialist about exercise plans
  • learning more about specific assistive and communicative devices for once the body is too weak to perform tasks
  • speaking with therapists who can help with eating, breathing, and speech as those processes become more difficult
  • having a home assessment done to determine how to make it most functional for future needs

Resources for help

If you or someone you love has recently been diagnosed with ALS, surrounding yourself with people who understand what you’re going through is important. The ALS Association has support groups available for individuals as well as their caretakers. You can also ask your doctor about other supports that may be available in your area.

Was this helpful?

ALS is a progressive disease that ultimately leads to death regardless of when it is diagnosed.

Three drugs may show some promise in helping relieve symptoms and even slow ALS progression. Those three medications are:

  • Riluzole: Research indicates that this first drug for ALS treatment may exhibit “neuro-protective activity,” possibly related to certain damage of the central nervous system.
  • Edaravone: This medication could also stop some of the ALS development and protect motor neuron from damage.
  • Sodium phenylbutyrate and taurursodiol: The Food and Drug Administration (FDA) approved this drug for treating ALS. Research studies show it can slow ALS clinical progression.

However, research is not clear on the benefits of those medications as it relates to ALS development and associated symptoms.

Scientists are also exploring the concept of cellular therapy to temporarily stall the disease progression or improve an individual’s quality of life.

Using stem cells as a treatment method is one of those avenues being investigated, and as that research progresses, the outlook for people with ALS will hopefully improve.

Some of the very early ALS symptoms may be easy to write off as clumsiness, tiredness, or just a delayed reaction. The muscle weakness may even be so slight that it’s not even noticeable.

However, these symptoms will eventually and increasingly limit a person’s ability to control their limbs.

Currently, there’s no cure for ALS. But treatments like medications are available and are typically successful in slowing ALS progression to a limited degree.

ALS is a chronic condition that worsens over time. Regardless of how early ALS is diagnosed, a person’s outlook generally remains the same.

But with continued ALS research, hope remains for more insight into the condition, including diagnosis and treatment.