Does ALS affect both legs at the same time?

Multifocal onset of symptoms was reported by 103 patients with ALS, UMN and LMN phenotypes (Table 2). Of these patients, 89 reported simultaneous onset in both legs or both arms.

Can ALS affect all limbs at once?

ALS may affect only one hand at first. Or, you may have problems in just one leg, making it hard to walk in a straight line. Over time, it affects almost all of the muscles you control. ALS doesn't affect all muscles and organs in the body.

Can ALS start in both legs at the same time?

Disease onset often occurs in one of two distinct ways: Limb Onset ALS or Bulbar Onset ALS. While disease onset is usually focal (symptoms start in one specific site – either limb or bulbar), multifocal (symptoms start in multiple sites) onset is possible and can occur in both limbs and bulbar regions simultaneously.

What does ALS feel like in the legs?

Weakness in your legs, feet or ankles. Hand weakness or clumsiness. Slurred speech or trouble swallowing. Muscle cramps and twitching in your arms, shoulders and tongue.

Does ALS start bilaterally?

However, the diagnosis of amyotrophic lateral sclerosis (ALS) is seen to be more accurate in up to 95% of cases with bilateral presentation but fell to almost 38% in patients with unilateral (hemiparetic) or pseudopolyneuritic forms.

Common ALS Symptoms

Is there leg pain with ALS?

The answer is yes, although in most cases it does so indirectly. From what we know at this time, the disease process in ALS only affects the nerve cells controlling strength (motor neurons) in the brain, spinal cord, and peripheral nerves.

Does ALS affect both sides of the body?

Early symptoms tend to be asymmetrical, which means they only happen on one side. As the condition progresses, the symptoms generally spread to both sides of the body. Muscle weakness, weight loss, and muscle atrophy are common. In the late stages of ALS, paralysis of the muscles occurs.

What muscles are affected first with ALS?

When ALS begins in the bulbar motor neurons, localized in the brainstem, the muscles used for swallowing and speaking are affected first. Rarely, symptoms begin in the respiratory muscles. As ALS progresses, symptoms become more widespread, and some muscles become paralyzed while others are weakened or unaffected.

What comes first in ALS muscle weakness or twitching?

What are the symptoms? The onset of ALS may be so subtle that the symptoms are overlooked. The earliest symptoms may include fasciculations (muscle twitches), cramps, tight and stiff muscles (spasticity), muscle weakness affecting a hand, arm, leg, or foot, slurred and nasal speech, or difficulty chewing or swallowing.

Where do ALS muscle twitches start?

To diagnosis ALS, a physician needs to see signs of progressive muscle weakness. What causes fasciculations? They originate at the very tips of the nerves, called axons, as they come close to being in contact with the muscle.

Does ALS start with numbness and tingling?

Although some CIDP symptoms may appear similar to those of ALS, ALS does not cause numbness, tingling, or uncomfortable sensations. Also, ALS commonly causes symptoms such as muscle twitching, weight loss, and muscle wasting as well as problems speaking, breathing, and swallowing.

Does ALS start in arms or legs?

The first sign of ALS usually appears in the hand or arm and can show as difficulty with simple tasks such as buttoning a shirt, writing, or turning a key in a lock. In other cases, symptoms initially affect one leg. People experience awkwardness when walking or running, or they may trip or stumble more often.

What does ALS spasticity feel like?

Upper motor neuron degeneration generally causes spasticity (tightness in a muscle), slowness of movement, poor balance and incoordination, while lower motor neuron degeneration causes muscle weakness, muscle atrophy (shrinkage of muscles) and twitching (fasciculations).

Is ALS weakness sudden or gradual?

Not all people with ALS experience the same symptoms or the same sequences or patterns of progression. However, progressive muscle weakness and paralysis are universally experienced. A gradual onset of progressive muscle weakness – which is generally painless – is the most common initial symptom in ALS.

How do you rule out ALS?

Electromyography: EMG is one of the most important tests used to diagnose ALS. Small electric shocks are sent through your nerves. Your doctor measures how fast they conduct electricity and whether they're damaged. A second part of the test also checks the electrical activity of your muscles.

How fast does ALS weakness progress?

Typically, the disease will progress over 2 to 5 years after diagnosis. However, 20% of patients live for more than 5 years, and about 5% live for 20 years or more. The name describes the condition. Amyotrophic comes from the Greek.

What parts of the body are generally not affected by ALS?

ALS does not affect a person's sensory functions or mental faculties. Other, nonmotor neurons, such as sensory neurons that bring information from sense organs to the brain, remain healthy.

Do ALS fasciculations stop with movement?

The twitching also affects the muscle while it is resting. However, it will stop when the person starts using the muscle. In ALS, twitching can start in one place.

How accurate is an EMG in detecting ALS?

The technique appears to identify people with ALS at about 96% accuracy. And, rule out ALS, 84%. Now, a growing number of neurophysiologists are using combined methods to identify people with ALS. The strategy reduces the number of muscles that need to be checked using electrophysiological methods – including EMG.

Do early ALS symptoms come and go?

With ALS, you may first have weakness in a limb that occurs over a few days or, more often, a few weeks. Then a few weeks or months later, weakness develops in another limb. For other people, the first sign of a problem may be slurred speech or trouble swallowing. As ALS progresses, more and more symptoms are noticed.

Does muscle twitching always mean ALS?

Having muscle weakness, fatigue, stiffness, and twitching doesn't mean that you have ALS. Those symptoms can also be caused by other conditions. It can be hard for your doctor to tell if you have ALS. It may not be clear that you have the disease until symptoms get worse or until your doctor has done more testing.

Is ALS ascending or descending paralysis?

Lou Gehrig's disease causes ascending muscle weakness and atrophy, as the upper and lower motor neurons seem to slowly degenerate.

Does ALS cause tingling in feet?

ALS doesn't cause numbness, tingling, or loss of feeling.

What were your first ALS symptoms?

Bulbar onset usually affects voice and swallowing first. The majority of ALS patients have limb onset. For these individuals, early symptoms may include dropping things, tripping, fatigue of the arms and legs, slurred speech and muscle cramps and twitches.