Legs

• People with ALS may notice weakness in one leg and start to have trouble walking or running. They may trip and stumble more than usual.
  
  

Arms/Hands

• Dexterity diminishes, making common tasks such as tying shoes and signing a check more difficult, as muscles in the arms weaken.
  
  

Speech/Swallowing

• For some ALS patients, slurred speech is an early symptom of the disease. Patients will eventually have trouble swallowing and chewing, making eating difficult and choking a risk.
  
  

Twitches/Cramps

• ALS patients suffer cramping and involuntary movement of their muscles as they atrophy. Some muscles will get tight and stiff, and reflexes, including the gag reflex, are heightened.
  
  

Breathing

• As the disease progresses, ALS patients are unable to breathe on their own due to atrophy of the respiratory muscles and will need a ventilator. Pneumonia becomes a greater possibility.