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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.