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ALS

ALS is a progressive disease of the nerve cells that control movement. It can affect walking, speaking, swallowing and breathing.

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  • Amyotrophic lateral sclerosis is a rare, progressive disease of the motor nerve cells that control muscles.
  • Symptoms may begin with weakness in a hand, arm or leg, or difficulties with speech or swallowing; sensation and bladder function often remain intact for a long time.
  • Muscle twitches or cramps alone usually do not mean ALS; progressively worsening measurable weakness and loss of function particularly need investigation.
  • No single test proves ALS on its own. A neurologist uses the pattern of symptoms, an examination and tests to rule out other causes.
  • There is currently no cure for ALS, but disease-modifying medicines can influence its course in some people, and many symptoms can be treated.
  • A specialist multidisciplinary team supports breathing, nutrition, communication, mobility, mood and planning.
  • Discuss what matters to you early and record your treatment wishes before communication or breathing becomes more difficult.
  • Sudden severe difficulty breathing, choking with an inability to breathe, or sudden new weakness may be an emergency and need not be due to ALS.

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Further reading

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Parkinson’s diseaseParkinson’s disease is a gradually progressive brain condition that can affect movement, sleep, thinking, mood, blood pressure, the bowel and other body functions. Sudden loss of function is not part of the usual course; never stop levodopa or other Parkinson’s medication abruptly, and have swallowing problems, falls or acute confusion assessed promptly.
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Neuralgic amyotrophyShoulder nerve inflammation, usually called neuralgic amyotrophy, often starts with sudden, very severe shoulder or arm pain, followed days to weeks later by weakness and muscle wasting. Early assessment is needed to rule out other emergency causes and safely support pain control, breathing and recovery.
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Spinal stenosisIn spinal stenosis, the space for the spinal cord or nerve roots becomes smaller. In the lower back, this often causes leg pain, tingling or weakness when standing and walking that eases with sitting or bending forwards; in the neck, pressure on the spinal cord may cause clumsy hands and walking difficulties. Inability to urinate, loss of bladder or bowel control, or numbness around the anus and genitals is an immediate emergency.