Lou Gehrig’s Syndrome: What Are the First Symptoms?
Lou Gehrig’s disease, medically called amyotrophic lateral sclerosis (ALS), is a progressive neurological disease that damages the motor nerve cells responsible for controlling voluntary muscles. Early symptoms can be subtle and vary considerably from person to person.
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1. Weakness in one hand or arm
One of the earliest signs can be difficulty performing tasks that used to be easy—such as buttoning clothes, opening jars, writing, or gripping objects. The weakness may initially affect only one side.
2. Tripping or difficulty walking
ALS can begin in the legs, causing weakness in the foot, ankle or leg. Someone might repeatedly trip, stumble, or find stairs increasingly difficult.
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3. Muscle twitching
Small involuntary muscle movements, called fasciculations, may appear in the arms, legs, shoulders or tongue. Twitching by itself, however, does not mean someone has ALS; it can occur for many other reasons.
4. Muscle cramps
Frequent or unusually persistent muscle cramps can occur, sometimes together with weakness or twitching.
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5. Clumsiness
A person may begin dropping objects, having trouble using keys or utensils, or struggling with fine movements. This is particularly important when the clumsiness is progressive rather than occasional.
6. Slurred or changed speech
When ALS affects the muscles involved in speaking, speech can become slurred, slower, quieter or difficult to understand.
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7. Difficulty swallowing
Trouble swallowing food or liquids, coughing while eating, or feeling that food gets stuck can occur when ALS affects the muscles used for swallowing.
8. Muscle wasting
As affected muscles become weaker, they may gradually become visibly smaller. Muscle wasting together with progressive weakness is an important finding doctors evaluate.
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9. Changes in laughing or crying
Some people develop episodes of laughing or crying that are difficult to control or don’t match how they actually feel. These are sometimes called pseudobulbar affect.
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10. Changes in thinking or behavior
Although ALS primarily affects movement, some people can experience cognitive or behavioral changes.
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Important: these symptoms don’t automatically mean ALS
Many much more common conditions can cause muscle twitching, weakness, cramps, difficulty walking, swallowing problems or speech changes. ALS can be difficult to diagnose in its early stages because its symptoms overlap with other disorders. Doctors use a neurological examination and tests such as electromyography (EMG) and nerve-conduction studies, while also investigating other possible causes.
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Mayo Clinic
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If someone has progressive, unexplained muscle weakness, especially when accompanied by muscle wasting, persistent twitching, slurred speech or swallowing difficulty, they should arrange an evaluation with a doctor—often a neurologist.
Sudden weakness or sudden trouble speaking is different: that can be a medical emergency, such as a stroke, and requires immediate emergency care.
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If you tell me which symptoms you’re experiencing and how long they’ve been happening, I can explain whether they are typical of ALS or whether other, more common causes might fit better.
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