Early Signs of ALS: Symptoms and Prevention Strategies

Early stage of amyotrophic lateral sclerosis (ALS)

Hello, doctor.
Recently, when I stand on my left foot, I feel a constant urge to engage my calf muscles (similar to the feeling of trying to maintain balance).
I am aware of this urge before it happens.
Additionally, when lying in bed, I have the urge to shake my leg, and I have noticed an increase in saliva production—not enough to drool, but I tend to spray saliva when I speak, which I didn't experience before.
Could this be an early sign of amyotrophic lateral sclerosis (ALS)? I visited a neurologist about two months ago, but the doctor only asked me to draw circles and said there was nothing wrong, so no further tests were needed.
At that time, I did not have the issues with saliva or my leg.
Are there any methods to prevent ALS?

Ju, 10~19 year old female. Ask Date: 2022/01/19

Dr. Jiang Junyi reply Neurology

Hello Mr.
Ju,
You mentioned "the early reactions of amyotrophic lateral sclerosis (ALS)?" ALS primarily refers to issues with motor neurons, which control muscle movement.
Generally, the motor neurons in the brain are referred to as upper motor neurons, while those in the brainstem and spinal cord are called lower motor neurons.
When motor neurons become diseased, our muscles do not receive adequate nutrients and chemicals, which can lead to muscle death.
You also asked, "What methods can prevent ALS?" The exact causes of motor neuron disease are often unknown, but potential factors include genetic predisposition, heavy metal toxicity, gene mutations, viral infections, deficiencies in growth hormones, and excessive excitotoxicity.
Since this disease is characterized by chronic muscle wasting, it can lead to muscle atrophy.
If upper motor neurons die, abnormal signal transmission may cause muscle twitching.
The signs of lower motor neuron involvement (muscle atrophy, weakness, and fasciculations) can almost definitively diagnose motor neuron disease, especially when upper motor neuron signs such as enhanced tendon reflexes, the Hoffman sign, and the Babinski reflex are observed in the same limb.
However, clinical diagnosis requires techniques such as electromyography (EMG) and muscle biopsy.
I recommend consulting a neurologist specializing in peripheral nerve disorders, as they have more experience with EMG diagnostics.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Neurologist, Taoyuan Hospital

Reply Date: 2022/01/19

More Info

The early signs of Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig's disease, can be subtle and often mistaken for other conditions. ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord, leading to loss of muscle control. Understanding the symptoms and potential prevention strategies is crucial for early detection and management.

Early Symptoms of ALS
1. Muscle Weakness: One of the most common early signs of ALS is muscle weakness, which may start in one limb and gradually spread to others. This can manifest as difficulty in performing daily tasks, such as buttoning a shirt or climbing stairs.

2. Muscle Twitches (Fasciculations): You may experience involuntary muscle twitches, particularly in the arms, legs, or tongue. These twitches can be benign but, in the context of other symptoms, may indicate ALS.

3. Stiffness and Spasticity: Some individuals report stiffness in their muscles, which can lead to spastic movements. This may be accompanied by cramps or tightness.

4. Changes in Speech and Swallowing: Difficulty speaking clearly (dysarthria) or swallowing (dysphagia) can occur as the muscles involved in these functions weaken. Increased salivation, as you mentioned, can also be a symptom.

5. Fatigue: Unexplained fatigue that does not improve with rest can be an early indicator of ALS.

6. Balance Issues: As muscle control diminishes, maintaining balance may become challenging, leading to falls or a feeling of unsteadiness.

Self-Assessment and Monitoring
While self-assessment can provide some insights, it is essential to consult a healthcare professional for a definitive diagnosis. Here are some self-check methods:
- Strength Tests: Try simple strength tests, such as holding a weight or performing a squat. Notice if one side feels weaker than the other.

- Reflexes: Pay attention to your reflexes. If you notice a significant change in how your body responds to stimuli, it may warrant further investigation.

- Speech Clarity: Record yourself speaking and listen for any changes in clarity or slurring.

When to Seek Medical Attention
If you notice a combination of the symptoms mentioned above, especially if they persist or worsen, it is essential to seek medical attention. A neurologist can perform a thorough examination, including electromyography (EMG) and nerve conduction studies, to assess the electrical activity of your muscles and the health of your motor neurons.

Prevention Strategies
Currently, there is no known way to prevent ALS, as its exact cause remains unclear. However, some general health tips may contribute to overall neurological health:
1. Healthy Diet: A balanced diet rich in antioxidants, omega-3 fatty acids, and vitamins may support brain health. Foods such as fish, nuts, fruits, and vegetables are beneficial.

2. Regular Exercise: Engaging in regular physical activity can help maintain muscle strength and overall health. However, it is essential to tailor exercise to your capabilities and avoid overexertion.

3. Avoiding Toxins: Reducing exposure to environmental toxins, such as pesticides and heavy metals, may lower the risk of developing neurodegenerative diseases.

4. Stress Management: Chronic stress can negatively impact health. Techniques such as mindfulness, meditation, and yoga can help manage stress levels.

5. Regular Check-ups: Routine medical check-ups can help monitor any changes in health and catch potential issues early.

In conclusion, while early signs of ALS can be concerning, they can also be indicative of various other conditions. It is crucial to maintain open communication with healthcare providers and seek further evaluation if symptoms persist. Early detection and intervention can significantly impact the management of ALS and improve quality of life.

Similar Q&A

Early Detection of ALS: EMG Tests and Self-Assessment Methods

Hello, doctor. Can electromyography (EMG) detect amyotrophic lateral sclerosis (ALS) in its "super early" stages? Additionally, is arm fatigue one of the early symptoms of ALS? Are there any self-assessment methods for ALS, such as whether one can open a bottle cap or b...

Dr. Hong Weibin reply Neurology
Hello: Sometimes, the early electromyography (EMG) findings in amyotrophic lateral sclerosis (ALS) can be atypical and difficult to interpret, which necessitates follow-up EMG testing after a period, such as six months. ALS is a motor neuron disease, primarily affecting motor fun...

Understanding Early Symptoms of Amyotrophic Lateral Sclerosis (ALS)

Hello, doctor. Recently, I have been experiencing some involuntary muscle twitching in my legs, and I also feel a lack of strength. However, I don't have much trouble when lifting things normally. About two months ago, I visited a neurologist, who asked me to draw circles on...

Dr. Hong Weibin reply Neurology
Hello: Regarding the symptoms of amyotrophic lateral sclerosis (ALS), you can refer to the CommonHealth Knowledge Base at https://kb.commonhealth.com.tw/library/417.html#data-3-collapse. However, if your symptoms are not progressively worsening, you can be reassured that it is us...

Understanding ALS Symptoms: When to Seek Medical Advice

I have been experiencing headaches since the beginning of last month. After the headaches subsided, I noticed weakness in my left hand, along with occasional soreness and numbness in my fingers, although it's not very pronounced. Recently, I feel like the muscles in my right...

Dr. Lan Shengxing reply Neurology
Hello, regarding the muscle twitching associated with amyotrophic lateral sclerosis (ALS), it's difficult to convey the actual sensation. In the clinic, visible muscle fasciculations can be observed, but the feelings of soreness and numbness are not characteristic of ALS. As...

Understanding ALS Symptoms: What to Expect and When to Seek Help

Hello Doctor, I started feeling weakness in my right hand and right foot when I got up on February 21. It feels unusual, but I can still exert strength if I try hard; otherwise, it feels soft as if I had engaged in intense exercise. My right hand also feels less agile than usual....

Dr. Jiang Junyi reply Neurology
Hello, Student Luo: You mentioned "EEG and upper and lower limb evoked potentials, and next month there will be an MRI." Essentially, EEG is not a diagnostic tool for motor neuron diseases. Your concern about amyotrophic lateral sclerosis (ALS) primarily refers to issu...