Early symptoms

The first symptoms of ALS can be different from person to person. A symptom alone does not mean ALS.

Weakness in the hand or arm

Dropping objects, difficulty buttoning clothes, weaker grip, changes in handwriting, or reduced hand coordination.

Weakness in the leg

Tripping, foot drop, dragging the foot, difficulty climbing stairs, or reduced strength in one leg.

Bulbar symptoms

Slurred speech, choking with food or liquids, difficulty chewing, voice changes or nasal-sounding speech.

Fasciculations

Small involuntary muscle twitches. They can occur in ALS but also in healthy people and many other conditions.

Cramps and stiffness

Painful cramps or muscle stiffness may occur early in some people, especially when upper motor neuron involvement is present.

Muscle atrophy

Loss of muscle bulk in an affected area may develop over time, often together with weakness.

When to seek medical help

Consult a neurologist if weakness is progressive, unexplained, or accompanied by changes in speech, swallowing, breathing or walking. Diagnosis requires professional evaluation and appropriate tests.