ALS Symptoms: Early Signs and Progression

Early symptoms of Amyotrophic Lateral Sclerosis (ALS) can be subtle and easy to miss. While there is currently no cure for ALS, early detection is crucial for management of the disease and maintaining higher quality of life. This article aims to highlight ALS symptoms to help people recognize them sooner and seek earlier treatment.

Early Symptoms

The onset of ALS is very subtle and can be easily overlooked. Initial symptoms are usually characterized by:

• Muscle Weakness: Subtle muscle weakness or stiffness, which typically occurs in one limb (arm or leg) or in the speech muscles.
• Slurred Speech: Difficulty with pronunciation and slower speech patterns may occur.
• Muscle Twitching: Noticeable twitching, and cramping, particularly in the hands and feet.
• Decrease Of Motor Skills: Tasks requiring fine motor skills are becoming difficult (buttoning a shirt, use of utensils, …)

Progressive ALS Symptoms

Since ALS is a progressive disease the early onset symptoms tend to worsen making life significantly difficult.

• Difficulty Swallowing: Some individuals often experience difficulty swallowing, which makes them at risk for choking.
• Muscle Weakness: Gradual weakness develops in the muscles. This causes a decrease in mobility and limits day-to-day activities.
• Paralysis: Muscles become non-functional as a result of muscle neuron degeneration, which can lead to paralysis in the later stages of the disease.
• Breathing Difficulties: Respiratory muscles weaken, making breathing significantly difficult. The breathing difficulties worsen with the progression of the disease, ultimately causing the individuals to need ventilatory support.

Emotional and Cognitive Symptoms

ALS is primarily a physical condition, however, the research showed that it can also have an emotional and cognitive impact. The new speculations suggest that ALS  does not only affect motor neurons but also neurons in the frontal and temporal lobe – areas which are responsible for cognitive and emotional functions.

• Emotional Instability: Some people with ALS experience excessive laughing or crying, often impulsive and completely disconnected from their emotional state.
• Cognitive Changes: Individuals may develop cognitive impairments or, more rarely, a form of dementia known as frontotemporal dementia (FTD).

Credits:
Mayo Clinic: ALS
National Institute of Neurological Disorders and Stroke: ALS
ALS Symptoms and Diagnosis
Achi, E. Y., & Rudnicki, S. A. (2012). ALS and frontotemporal dysfunction: A review.
Mezzapesa, D. M., Ceccarelli, A., Dicuonzo, F., Carella, A., De Caro, M. F., Lopez, M., Samarelli, V., Livrea, P., & Simone, I. L. (2007). Whole-brain and regional brain atrophy in amyotrophic lateral sclerosis