The most common symptoms are- muscle weakness, twitching (fasciculation) and cramping of muscles, mostly in the hands and feet, impairment
and difficulty of
the use of
the arms
and legs, thick speech, shortness of breath, difficulty in breathing and swallowing. Muscle weakness is the specific initial sign in ALS, but early symptoms vary from person to person. It may start with tripping, dropping things, abnormal fatigue of the arms and/or legs, slurred speech, muscle cramps or twitches.