Symptoms are what you experience or feel, whereas signs are what can be seen or measured. Symptoms and signs of ALS, and the order in which they occur, vary from one person to another. In the early stages, they may seem trivial or be dismissed as normal signs of aging.

Potential early signs

  • Tripping
  • Dropping things
  • Slurred or “thick” speech
  • Difficulty swallowing
  • Weight loss
  • Decreased muscle tone
  • Shortness of breath
  • Increased or decreased reflexes
  • Uncontrollable periods of laughing or crying

Potential early symptoms

  • Feeling weak
  • Fatigue
  • Muscle cramping or twitching
  • Muscle stiffness or rigidity

Over time, the muscle weakening will continue to spread throughout the body, eventually causing difficulties with breathing, chewing, swallowing and speaking.*

The senses of sight, touch, hearing, taste and smell are usually not affected, and for many people, muscles of the eyes and bladder remain functional until very late in the disease.*

ALS and pain

While pain is not commonly reported by people living with ALS, some people experience physical pain, joint discomfort or cramping. Movement exercises and keeping warm can help alleviate the feelings of pain. Medication may also be needed in some cases. Learn more.


*Sources:                                                                                                                                                                                                                 Current as of November 14, 2016.