# Lou Gehrig’s Disease: Early Symptoms of ALS You Should Know
Amyotrophic lateral sclerosis, better known as **ALS or Lou Gehrig’s disease**, is a progressive neurological condition that damages the motor neurons responsible for controlling voluntary muscle movement.
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ALS can be difficult to recognize in its early stages because symptoms may begin subtly and can resemble many other conditions. Early signs often involve **progressive muscle weakness, twitching, cramping, clumsiness, speech changes, or difficulty swallowing**. ([Mayo Clinic][1])
Having one of these symptoms does **not** mean someone has ALS. Diagnosis requires a neurological examination and testing to rule out other possible causes.
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## 1. Increasing Weakness in One Hand or Arm
ALS may begin with weakness in a single limb.
A person might notice that they:
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* Drop objects more often
* Have difficulty turning keys
* Struggle to button clothing
* Cannot grip objects as firmly
* Have trouble writing or using utensils
The weakness typically becomes progressively more noticeable rather than appearing once and disappearing. Hand weakness and clumsiness are among recognized early symptoms of ALS. ([Mayo Clinic][1])
## 2. Weakness in the Foot, Ankle, or Leg
àFor some people, ALS starts in the lower limbs.
Possible early signs include:
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* Difficulty lifting the front of the foot
* Repeatedly catching the toes while walking
* An ankle that feels unusually weak
* Increasing difficulty climbing stairs
Mayo Clinic lists weakness in the legs, feet, or ankles among common early presentations. ([Mayo Clinic][1])
## 3. Frequent Tripping or Falling
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Unexplained trips and falls can occur when leg or foot muscles become weaker.
Someone who previously walked normally may begin:
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* Stumbling on flat surfaces
* Catching a foot on rugs or steps
* Losing balance more often
* Having trouble with routine walking
ALS is only one of many possible causes of frequent falls. Joint problems, medications, vision changes, inner-ear disorders, peripheral neuropathy, and other neurological conditions can cause similar symptoms. ([Mayo Clinic][1])
## 4. Muscle Twitching
Small involuntary muscle twitches, known as **fasciculations**, are commonly associated with ALS.
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They may occur in areas such as the:
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* Arms
* Shoulders
* Legs
* Tongue
However, muscle twitching is extremely common and can also happen because of exercise, stress, caffeine, sleep deprivation, or other benign causes.
