Amyotrophic Lateral Sclerosis (ALS) Signs and Symptoms
- Many people experience the initial symptoms of amyotrophic lateral sclerosis (ALS) so gradually, they don't promptly recognize a change.
- Some individuals first notice difficulty with simple tasks like buttoning a shirt or tying shoes.
- Importantly, bowel and bladder control, and also the senses of hearing, sight, smell, taste, and touch, are usually unaffected by ALS.
Understanding Amyotrophic Lateral Sclerosis (ALS)
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Many people experience the initial symptoms of amyotrophic lateral sclerosis (ALS) so gradually, they don’t promptly recognize a change. Typically, symptoms begin in the hands, feet, arms, or legs – what’s known as limb onset ALS. As more nerve cells deteriorate and muscles weaken, the condition spreads to other parts of the body. The speed of progression varies, but ALS ultimately leads to the loss of the ability to stand, walk, use your limbs, swallow, speak, and breathe.
Early Signs of ALS
Some individuals first notice difficulty with simple tasks like buttoning a shirt or tying shoes. Others experience increased tripping. Common early signs and symptoms include:
- Tripping and falling or difficulty walking
- Feeling clumsy
- Weakness in hands, legs, feet, or ankles
- Muscle cramps and tightness
- Twitching in arms, shoulders, and tongue
- Difficulty keeping your head up or maintaining good posture
- Slurred speech and trouble swallowing
- Breathing difficulty
Importantly, bowel and bladder control, and also the senses of hearing, sight, smell, taste, and touch, are usually unaffected by ALS.
Cognitive and Behavioral Changes
while historically thought to spare cognitive function, recent research indicates that a significant percentage of people with ALS experience cognitive or behavioral impairments. These can manifest as difficulties with:
- Reasoning
- Judgment
- Planning
- Emotional regulation
- Self-awareness
Associated behaviors may include pacing, repeating actions or phrases, rumination, anxiety, emotional reactivity, social withdrawal, indifference, and a lack of empathy.
Depression and ALS
A diagnosis of a serious illness like ALS can understandably lead to depression. A 2016 study of Swedish health records found that individuals with ALS are at a higher risk of depression both before and after diagnosis. This increased risk before diagnosis could be due to depression being an early sign of ALS, a symptom of frontal lobe degeneration, a manifestation of cognitive impairment, or a psychological response to early, undiagnosed symptoms. Following diagnosis, depression likely stems from the emotional impact of receiving a life-threatening illness.
Symptoms of depression in someone with ALS can include sadness,guilt,sleep problems,appetite changes,and irritability.