Because of this, a battery of tests is required to definitively determine that ALS is present. However, most ALS patients experience a gradual onset of symptoms that become more severe. The beginning symptoms could be a simple as having difficulty buttoning your shirt, grasping and object, or even experiencing changes in pitch when speaking. Most of the first symptoms are associated with the inability to control muscles effectively, and begins with weakness in limbs, often worse on one side than the other. Other early symptoms may include tripping, muscle fatigue, muscle cramps/twitches, or uncontrollable periods of laughter or crying. Eventually the muscle degeneration will become extremely problematic, especially when the muscles associated with breathing become affected.
As stated earlier, ALS is a difficult disease to diagnose because it shares symptoms with other diseases such as Primary Lateral Sclerosis. First a neurological exam is performed by a neurologist who will look for muscle weakness, twitches caused by lower motor neuron activity, hyperactive reflexes and tight muscles caused by upper neuron activity, and evaluate the muscles associated with speech, chewing, and swallowing. They will also evaluate the patient’s sensation loss and pain