Symptoms of ALS Tips

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What symptoms can I expect with upper motor neuron involvement?

Upper Motor Neuron Symptoms

Symptoms revealing upper motor neuron involvement include:

Loss of dexterity or the ability to coordinate movements

Loss of muscle strength

Spasticity or muscle stiffness

Hyperreflexia or increased reflexes

Spastic Bulbar Palsy

Spastic Bulbar Palsy is a syndrome characterized by Dysphagia or difficulty swallowing, tongue involvement, Dysarthria or difficulty speaking, and slurred or nasally speech.

What symptoms can I expect with lower motor neuron involvement?

Lower Motor Neuron Symptoms

As you can see from the list below, lower motor neuron disease symptoms are different than upper motor neuron disease symptoms:

Loss of muscle strength

Muscle Atrophy


Muscle Hypotonicity or Flaccidity


Muscle cramps

"Spastic bulbar palsy" sounds complicated. What is it exactly?

Bulbar-onset ALS

There are many ways in which this disease can affect the facial area. The face is innervated by a variety of cranial nerves, some of which are located in the lower part of the brain called the medulla or “bulb”. Injury or problems to this area will produce the condition known as “spastic bulbar palsy”.

As stated briefly before, symptoms ssociated with spastic bulbar palsy include difficulty with swallowing, speaking, or chewing food. Some might have problems with being able to completely close their eyelids or mouth. While another common feature of spastic bulbar palsy is drooling, which is causes embarrassment to the person. The tongue can also experience fasciculations or tremors, and develop a wavy pattern.

Other symptoms of spastic bulbar palsy include the aspiration of food, which means choking when food enters the trachea or windpipe. Bulbar-onset ALS is seen in a small percentage of ALS patients.

What are motor neurons?

Motor Neurons

Motor neurons are located within the brain and spinal cord and are divided into two main groups – the upper and lower motor neurons. The upper motor neurons are travel from mainly the cortex of the brain and control the lower motor neurons found within the spinal cord that travel to the muscles. As the disease progresses, upper and lower motor neurons will stop functioning, resulting in symptoms of ALS.

Which symptoms am I not likely to experience with ALS?

Rare Symptoms Of ALS

Typically, ALS does not produce feelings of pain or changes in the mental status. However, in a limited amount of people, there are rare symptoms of:



Bladder and bowel problems

Can I expect any other symptoms as I battle ALS?

Other Symptoms Of ALS

Other symptoms seen in ALS are quite varied as shown in this list:

Difficulty breathing

Overactive gag reflex

Crying or laughing uncontrollably

Anxiety and depression

Feeling of unsteadiness

Foot drop

Weight loss



Claw Hand

What symptoms can I expect during the early stages of this disease?

Symptoms During The Early Stages

If you are diagnosed with ALS or know someone with the disease, it will be overwhelming to think about what symptoms to expect. Generally, the symptoms of ALS are not the same for everybody, especially during the early stages of the disease. They can start in one area of the body and eventually progress to other areas. Symptoms can also start in the facial muscles, which move the tongue, or someone might notice weakness in the muscles of the hands and arms. The disease has usually progressed by the time a doctor's appointment is made.

More than 60 percent of people diagnosed will complain of weakness. Thirty-three percent of these people will complain of weakness in the arm, while the other 33 percent will complain of weakness in the ankle or leg. The remaining amount of people will have general weakness over their entire body. Usually the common picture of someone with ALS includes a person who has slurred speech, trips or drops things, with muscle weakness, twitching, or cramps.

What is the difference between Limb-onset ALS versus Bulbar-onset ALS?

Limb-onset ALS

Your doctor might have told you a diagnosis of limb-onset or bulbar-onset ALS. Limb-onset ALS is used to characterized a newly diagnosed ALS patient whose main symptoms begin either in the upper or lower limbs. These symptoms can include weakness in the hands and wrist or legs and ankle.

Limb-onset ALS is in contrast to bulbar-onset ALS where the main symptoms at the time of diagnosis involve the facial muscles, and muscles of the tongue and throat.

What can I expect during the end stages of ALS?

Symptoms During The End Stages

ALS is a fatal disease. According to medical resources, anyone diagnosed with ALS will live an average of two to five years after being diagnosed. Ten percent of initially diagnosed will live for ten years after this diagnosis. Since ALS is a motor neuron disease affecting the skeletal muscles, ALS patients will suffer from respiratory failure when their respiratory muscles stop functioning. A respirator can be used for breathing when respiratory failure occurs.

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Jerry Mayo