Symptoms and Signs of Amyotrophic Lateral Sclerosis (ALS)

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 11/15/2021

Doctor's Notes on Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that affects 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

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 the 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 the 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.

What Is the Treatment for Amyotrophic Lateral Sclerosis (ALS)?

Treatment of amyotrophic lateral sclerosis (ALS) is aimed at slowing the progression and assisting with the symptoms that cause complications. Supportive care and physical assistive devices make up many of the treatments available for ALS.

Medications approved to treat ALS include:

Other medications are used for the symptoms of ALS such as pain medications, anti-spasm mediations, and antidepressants.

Supportive care and assistive devices are the mainstays of treatment for the progressive symptoms of ALS. Assistive devices most commonly needed are:

  • PEG tube or feeding tubes for nutrition and hydration
  • Mobility devices 
    • Cane 
    • Wheelchair
  • Computer-assisted communication devices
  • Oxygen devices 
    • Breathing machines 
    • Masks 
    • Tracheostomy

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