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Early Symptoms of Lou Gehrig Disease

By Jennifer Markowitz, MD ; Updated August 14, 2017

Lou Gehrig disease -- also called amyotrophic lateral sclerosis -- is one of the most feared progressive neurological diseases. Involving degeneration of the brain and spinal cord, its early symptoms may be mild and vary from one person to another. Symptoms worsen with time, and the disease causes death on average within 3 to 5 years, according to the ALS Association.

Muscle Symptoms

Muscle weakness is the first symptom in 60 percent of people with Lou Gehrig disease, reports the ALS Association. Arm and hand weakness may show up as trouble buttoning clothes, opening containers or lifting things. Leg weakness may show up as tripping and falling. Some muscles, especially in the legs, may be stiff, and muscle cramps can occur. Muscle twitches are also usually present -- these are small, involuntary movements of parts of muscles that can be seen and felt. Fatigue is common. People with Lou Gehrig disease do not have problems with their senses -- touch, vision, hearing -- or with bladder and bowel function.

Trouble Speaking or Swallowing

Difficulties speaking and swallowing are common in Lou Gehrig disease, and in some people they are the first symptoms. Speech can sound slurred or thick and may be very soft. Trouble swallowing can show up as food sticking in the throat or liquids coming out of the nose. In this situation, there is a risk of food going down the wrong way into the lungs, known as aspiration, which can cause pneumonia.

Trouble Breathing

While trouble breathing usually happens later in the course of Lou Gehrig disease and is often the cause of death, it occurs early on in some people. Along with difficulty speaking and swallowing, trouble breathing is a risk factor for faster progression of the disease. Symptoms of breathing difficulty can be subtle -- for instance, headaches in the morning, poor sleep, fatigue and falling asleep during the day. All patients with suspected Lou Gehrig disease should have testing performed to be sure they are able to breathe adequately when awake and asleep.

Problems With Thinking and Emotion

Problems with control of emotion are common in Lou Gehrig disease. People may find themselves crying or laughing unintentionally. According to a review in the October-December 2009 issue of "Amyotrophic Lateral Sclerosis," up to half of all people with Lou Gehrig disease may have some subtle difficulty with thinking, and 5 percent to 10 percent have a severe problem called frontotemporal dementia. This involves trouble with judgment, planning, language and emotions.

When to Seek Medical Attention

Seek immediate medical attention if you have difficulty speaking or swallowing, obvious difficulty with breathing or sudden onset of weakness. Weakness that occurs abruptly may indicate that you have another serious condition instead, such as a stroke. Contact your doctor if you have any of the more subtle symptoms of a breathing problem or if you have a more gradual onset of muscle weakness, especially when accompanied by twitches or stiffness.

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