ALS: Sign and Symptoms

Question 1

ALS: Signs and Symptoms

Answer 1

75-80% of patients, symptoms begin with limb involvement

A. Lower limb onset
B. Upper limb onset

C. Bulbar onset symptoms first appear in the face or neck (20-25% initial complaints)

D. Emotional and Special Cognitive Difficulties

E. Features of more advanced
F. Progression of Bulbar Disease

Question 2

ALS: Signs and Symptoms

Lower limb complaints

Answer 2

Tripping, stumbling, or awkwardness when running

Foot drop
Slapping gait

Question 3

ALS: Signs and Symptoms

Upper limb complaints

Answer 3

Reduced finger dexterity
Cramping and stiffness

Weakness or wasting of intrinsic hand muscles

Wrist drop interfering with work performance

Question 4

ALS: Signs and Symptoms

Bulbar onset symptoms first appear in the face or neck (20-25% initial complaints)

Answer 4

Slurred speech
Hoarseness or decreased volume of speech

Aspiration or choking during a meal

Question 5

ALS: Signs and Symptoms

Emotional and Special Cognitive Difficulties in some ALS patients

Answer 5

Involuntary laughing or crying
Depression
Impaired executive function
Maladaptive social behavior

Question 6

ALS: Signs and Symptoms

Features of more-advanced disease are as follows

Answer 6

Muscle atrophy becomes more apparent

Spasticity may compromise gait and maintain dexterity

Muscle cramps are common

Rarely, painful joint contractures may result from immobility

Question 7

ALS: Signs and Symptoms

Progression of bulbar disease leads to the following

Answer 7

Voice change: hypernasality and development of a strained, strangled voice quality; eventually, speech may be lost

Swallowing difficulties, usually starting with liquids

Drooling