Motor Neuron Disease (MND) is a neurodegenerative disease that affects both the upper and lower motor neurons. Nerve cells are specialized cells that carry messages from one part of the body to another by transmitting electrical nerve impulses. Motor neuron degeneration causes muscle weakness and atrophy, resulting in a variety of symptoms including decreased mobility, speaking, swallowing, and breathing issues. Not everyone with motor neuron disease has all of these symptoms; for instance, it is normal to have clear and understandable speech throughout the condition.
ALS has varied symptoms, which differ from one person to another. In most of the cases ALS affects the regular activities of the individuals. The onset of ALS is quite subtle and thus the symptoms remain either overlooked or misread. At the beginning of ALS there are only mild symptoms. The most common initial symptom of ALS includes progressive, painless muscle weakness. There are several early signs of ALS, which should not be ignored by people.
10 early signs of ALS include the following:
- Muscle Cramps and Muscle Stiffness (Spasticity) – are the most common symptom of ALS. There are variations in the frequency and the severity of the cramps among the ALS patients; few patients experience frequent cramps, while some experience less frequent cramps. The prevalence of cramps has been found to be constant from diagnosis till later stages of ALS.
- Weakness of Muscles– The muscles of arms, legs, neck, and diaphragm become weak and soft as there is muscle atrophy thus leading to a problem with balancing.
- Fasciculation or Muscle Twitches –are a common symptom of ALS. These persistent muscle twitches mostly involve the muscles of the arm, shoulder, leg, and tongue and occur due to ongoing disruption of signals from the nerves to the muscles. Fasciculation is usually not painful but irritating and disrupts the sleep cycle of the patients.
- Hand Weakness– The most common early symptom of ALS is a painless weakness in hands leading to difficulty in grip and a tendency to drop things. Thus the individuals face difficulty in lifting a pen when writing, buttoning a shirt, turning a key into a lock, lifting or holding a coffee cup etc.
- Weakness in Leg– This occurs in ALS patients due to weakening of the leg muscles. This creates a problem with balancing, leading to tripping or staggering while walking or running.
- Fatigue– The relentless progression of the disease causes generalized weakness with loss of movements, decreased endurance and functionality, and also reduced ability to perform normal everyday activities. Fatigue can occur due to different reasons including muscular alterations, reduced physical resistance etc.
- Speech Problem– This occurs when bulbar neurons are affected. In some ALS patients, muscles of tongue, lips, vocal cords, and chest undergo atrophy. Thus, the individuals have speaking difficulties also known as ‘dysarthria’. This condition is characterized by slow, effortful, and slurred nasal speech.
- Problem with Chewing or Swallowing– This is a common condition in ALS that occurs due to weakening of the throat and mouth muscles, as a result there is a risk of excessive choking while eating.
- Breathing Problem– When the muscles involved in breathing weaken, a person faces difficulty to inhale or exhale and take shorter and shallower breaths. Shortness of breath occurs during vigorous physical activities like running, walking long distances, climbing stairs, or exercising. The individual thus gets tired quickly and develops headache and also undergoes restless sleep.
- Uncontrolled Crying or Laughter– Spells of uncontrolled laughter and crying is well known in ALS patients. These emotional spells typically occur due to the involvement of bulbar neurons in ALS patients and show disparity between the patient’s emotional expression and his or her emotional experience.
Changes in cognition (behavior and thinking) occur in half of those diagnosed, but they are usually minor. A tiny percentage of these people may develop frontotemporal dementia, which is a kind of dementia. Occasionally, following a diagnosis, people realise they had other symptoms that they had overlooked or attributed to a different source at the time.
Uncommon Types of MND
Amyotrophic lateral sclerosis (ALS), Progressive bulbar palsy (PBP), Progressive muscular atrophy (PMA), and Primary lateral sclerosis (PLS) are all different types of MND that affect people differently. There can be a massive overlap between all of them, so while it’s helpful to distinguish the different ways the disease manifests itself, it’s not always practical in reality. This is especially true as the disease advances.
A few patients with MND will be informed they have a less common form of the disease called PLS (primary lateral sclerosis) or PMA (progressive muscular atrophy). Just the upper motor neurons are affected by PLS, while the lower motor neurons are affected by PMA. Because the early symptoms of these kinds are so similar to those of other, more frequent cases of the disease, it can be tough to predict them apart in the early stages. People with these kinds of MND live longer than those with more common forms, but they face many of the same issues with increasing impairment.