Early symptoms of ALS

The early symptoms of ALS (amyotrophic lateral sclerosis) do not include a career .340 batting average, a .632 slugging average, and a .447 on base average. In fact, this condition is known as Lou Gehrig's disease because the legendary baseball player brought notoriety to ALS when he was diagnosed with it in the 1930’s, following a then mysterious loss of strength and underwhelming performance – by his usual standards – on the diamond.

Early ALS symptoms include the following:

  • Difficulty walking.
  • Tripping.
  • Difficulty doing normal everyday activities.
  • Weakness in the arms, legs, feet or ankles.
  • Nasal and slurred speech.
  • Trouble chewing and swallowing.
  • Difficulty holding head up or keeping good posture.
  • Fasciculations (brief, spontaneous contraction of a small number of muscle fibers, which may cause a flicker of movement under the skin).
  • Cramps.
  • Tight, stiff muscles.

The earliest signs of ALS appear on the part of the body where the affected muscles are. For example, some people find it hard to button a shirt or turning a key because the symptoms manifest first in the hands or arms. Conversely, others have problems walking or running because the condition starts in their legs and feet. Yet others begin experience speech problems. But whether Lou Gehrig's disease originally affects the arms or legs (limb onset ALS) or impairs speaking and swallowing (bulbar onset ALS), the fact remains that if untreated, amyotrophic lateral sclerosis will spread gradually to other body parts and lead to complications such as:

Breathing problems

The most number one cause of death for ALS patients is respiratory failure (death occurs 3-5 years on average after the onset of symptoms).

Speaking problems

People with ALS often have to use other communication technologies to express themselves.

Eating problems

Including malnutrition and dehydration, as well as aspirating food, liquids, and saliva into the lungs and potentially causing pneumonia. This risk can be decreased with a feeding tube.


Specifically, frontotemporal dementia, which early signs include memory and decision-making problems.

Though not nearly as shocking as when the Iron Horse was diagnosed by Charles William Mayo himself, the condition remains difficult to detect in its early stages because it may resemble other neurological disorders. For a diagnosis to be established, the early symptoms of ALS must include both upper and lower motor neuron damage.

Upper motor neuron symptoms

Lower motor neuron symptoms

  • Spasticity and exaggerated reflexes.
  • Overactive gag reflex.
  • Babinski’s sign (in which the large toe extends upward as the sole of the foot is stimulated in a certain way).
  • Muscle weakness and atrophy.
  • Muscle cramps.
  • Fasciculations.

A doctor can perform several tests to confirm Lou Gehrig’s disease as well as rule other conditions. Such tests may include:

  • Electromyogram.
  • Nerve conduction study.
  • Magnetic resonance imaging.
  • Blood and urine tests.
  • Spinal tap.
  • Muscle biopsy.

There is no cure for ALS, but medication and therapy can slow down the symptoms, prevent complications, and improve the quality of life of the patient.

Treatment for ALS


  • Riluzole (Rilutek) is the only FDA-approved medication for ALS.
  • Other prescription drugs may relieve symptoms such as constipation, fatigue, pain, depression, and others.


  • Breathing care.
  • Physical therapy.
  • Occupational therapy.
  • Speech therapy.
  • Nutritional support.
  • Psychological and social support.

Amyotrophic lateral sclerosis seems to affect people at random, but especially those with a family history of the disorder and people aged 40-60. Men under 65 are at a slightly increased risk than women. Additionally smoking, lead exposure, and serving in the military have been linked to a higher risk of developing ALS. Even though this condition is incommensurately taxing – it takes quite a disease to get someone who has played 1,230 consecutive games to bench himself – it is important to not get hung up on the physical changes. ALS seldom affects a person’s cognitive abilities, nor does it affect the bladder or bowels. Support from loved ones and from ALS groups is also essential. Remember that even after everything, Lou Gehrig still considered himself “the luckiest man on the face of the earth.”



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