What are the symptoms?

At the onset of ALS the symptoms may be so slight that they are frequently overlooked. With regard to the appearance of symptoms and the progression of the illness, the symptoms of the disease may include the following:

  • muscle weakness in one or more of the following: hands, arms, legs, the muscles of speech, chewing, swallowing or breathing
  • twitching (fasciculation) and cramping of muscles, especially those in the hands and feet
  • impairment of the use of the arms and legs
  • "thick speech" and difficulty in projecting the voice
  • in more advanced stages, shortness of breath, difficulty in breathing and swallowing

Muscle weakness is a hallmark initial sign in ALS, occurring in approximately 60% of patients. Early symptoms vary with each individual, but can include tripping, dropping things, abnormal fatigue of the arms and/or legs, slurred speech, trouble chewing/swallowing, muscle cramps and twitches, and/or uncontrollable periods of laughing or crying. Up to 50% of people with ALS may also experience Cognitive changes, called "Frontotemporal Lobar Degeneration," or FTLD. These symptoms may be mild to severe and include:

  • Less sensitive to needs of others
  • Inappropriate behavior
  • Childlike
  • Withdrawn, needing prompting
  • Changes in eating behavior
  • Fixation on specific idea or activity
  • Poor decision making, difficulty solving problems
  • Aggressive

Not all people with ALS experience the same symptoms or the same sequences or patterns of progression. But, progressive muscle weakness and paralysis of the voluntary muscles are universally experienced.

The rate at which ALS progresses can be quite variable from one person to another. Although the mean survival time with ALS is two to five years, some people live five, ten or more years. In a small number of people, ALS is known to remit or halt its progression, though there is no scientific understanding as to how and why this happen.

ALS does not affect internal organs like the heart, liver, kidneys or lungs, sexual function, or the senses.


The ALS Association Greater Philadelphia Chapter
321 Norristown Road - Suite 260, Ambler, PA 19002

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