![Picture](/uploads/1/9/1/2/19122637/7221026_orig.jpg)
ALS has many symptoms, all of which are related with muscles since the motor neurons have degenerated making it impossible for the body to control voluntary muscles (this degeneration is progressive). Some of the symptoms include:
- Muscle weakness - Weakness in the muscles, especially in the arm or leg. Around 75% of ALS cases have this as an initial symptom.
- Muscle atrophy - Shrinkage of the muscles caused by the decreasing of muscle mass. Initial symptom in 75% of ALS cases.
- Spasticity - Also referred to as muscle tightness, this is the condition in which muscles contract excessively.
- Trouble swallowing or breathing - Around 25% of ALS cases begin with this.
- Muscle cramps - Muscles that involuntarily contract and do not relax.
- Hyperreflexia - Overactive reflexes that can cause muscle twitching/contractions or spastic actions. Also includes an overactive gag reflex which is used to expel harmful substances.
- Difficulty in walking
- Not able to move arms or hands
- Lose ability to speak
- Problems with breathing which can eventually lead to respiratory failure (the primary cause of death in ALS cases)
- Difficulty in chewing and swallowing food
- In the late stages of ALS, the patient can be in a state similar to locked-in syndrome in which all voluntary muscles in the body are paralyzed except for the eyes. The eyes are generally not affected since they are controlled by the oculomotor nerve which is not affected by ALS until its very late stages.