Lou Gehrig’s Disease: Early Symptoms to Know
Lou Gehrig’s disease, medically called amyotrophic lateral sclerosis (ALS), is a progressive neurological disease that damages motor neurons—the nerve cells responsible for controlling voluntary muscles.
Early symptoms can vary considerably depending on which muscles are affected first.
Common early symptoms
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Muscle weakness: Often begins in one hand, arm, leg, or foot and gradually worsens.
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Difficulty with fine movements: Trouble buttoning clothes, turning keys, writing, or handling small objects.
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Tripping or foot weakness: A person may stumble more often or have difficulty lifting the front of the foot.
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Muscle twitching (fasciculations): Small, involuntary muscle twitches can occur, sometimes before obvious weakness.
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Muscle cramps or stiffness: Particularly in the affected limbs.
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Speech changes: Slurred, slower, or unusually nasal speech can occur when muscles involved in speaking are affected.
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Difficulty swallowing: Food or liquids may become harder to swallow, particularly in forms of ALS that initially affect speech and swallowing muscles.
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Changes in emotional expression: Some people develop inappropriate or uncontrollable laughing or crying (pseudobulbar affect).
An important distinction
Having muscle twitching, cramps, weakness, or difficulty walking does not mean someone has ALS. Many much more common conditions—including nerve compression, vitamin deficiencies, medication effects, thyroid disorders, and other neurological conditions—can cause similar symptoms.
ALS is diagnosed through a neurological examination and appropriate testing, rather than from symptoms alone.
If someone develops progressive, unexplained muscle weakness, particularly weakness that keeps spreading or worsening, they should arrange a medical evaluation with a doctor or neurologist. Sudden weakness on one side of the body, however, is an emergency because it can indicate a stroke.
