Symptoms and Signs of Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's Disease)

Doctor's Notes on Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's Disease)

Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that affects of the part of the nervous system that controls voluntary movements. It is also referred to as Lou Gehrig's disease for the famous baseball player who died of the disease. The muscles become progressively weaker, and the condition eventually leads to paralysis and death. The effects of ALS are not reversible and there is no cure.

Early symptoms of amyotrophic lateral sclerosis may be subtle and include weakness, awkwardness, atrophy in one or more limbs, or difficulty swallowing or speaking. In addition, common symptoms of ALS include difficulty standing, walking, or running; clumsiness; difficulty with fine hand motions such as buttoning, writing, turning a key in a lock; atrophy of hand muscles, atrophy of tongue, difficulty chewing food, oversensitive gag reflex, difficulty forming words, weakness and atrophy in specific muscles, stiff muscles, muscle cramps, and muscle twitching visible under skin. Depression and anxiety may occur in ALS patients and are believed to be part of the disease process. Some patients may have symptoms such as involuntary, uncontrolled outbursts of crying or laughter, which is different than their underlying mood. As the disease progresses, ALS causes the loss of ability to carry out everyday activities and as respiratory muscles weaken, breathing becomes more difficult. Most people with ALS die within five years of the onset of symptoms.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.