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The rate of disease progression and the sequence of symptoms varies from person to person. Everyone is different. The distinguishing characteristic of this disease is that it affects the upper and the lower motor neurons.

The signs and symptoms of upper motor neuron degeneration are muscle weakness, spasticity, and hyperreflexia, and those of lower motor neuron degeneration are muscle weakness, atrophy, fasciculations, hypotonia, and areflexia. ALS progresses relentlessly, and cases of stabilization of symptoms are few, with death resulting within an average of 2 to 5 years.

  1. Reflexes may be abnormal, including loss of the gag reflex.
  2. The gait may be stiff or clumsy.
  3. Muscle tremors, spasms, twitching or muscle atrophy (loss of tissue)
  4. Loss of muscle mass causes the limbs to become very thin.
  5. Muscle weakness, decrease in muscle strength and coordination
  6. Gradual onset, progressively worsens
  7. Commonly involves 1 limb (such as the hand)
  8. Progresses to difficulty lifting, climbing stairs
  9. Muscle cramps
  10. Voice changes, hoarseness
  11. Speech impairment, slow or abnormal speech pattern
  12. Difficulty swallowing, gags or chokes easily
  13. Difficulty breathing (increasing effort required to breathe)
  14. Usually tripping, dropping things
  15. Around 1545% of patients experience pseudobulbar affect, also known as "emotional lability", which consists of uncontrollable laughter or crying

Since ALS affects only motor neurons, the senses of sight, touch, hearing, taste and smell, muscles of the eyes and bladder are generally not affected.

Additional symptoms that may be associated with this disease:

  1. Urinary frequency/urgency, increased
  2. Ankle, feet, and leg swelling

"Hope Springs Eternal." Even if no other diagnosis seems likely, hope of a less serious outcome must be preserved; Other types of MND are less malignant.
Do not crush all hope;  
Dr. Forbes H. Norris, Jr.

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