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Early signs and symptoms of ALS include: 1  Difficulty walking or doing your normal daily activities. 2  Tripping and falling. 3  Weakness in your leg, feet or ankles.  Hand weakness or 1  clumsiness. Slurred speech or trouble swallowing.  Muscle cramps and twitching in your arms, shoulders and 1  tongue. Difficulty holding your head up or keeping good posture.
The early onset of ALS is often very subtle-these are the first Symptoms of ALS to watch for: 1  twitching and cramping of the muscles, especially those in the hands and feet. 2  muscle weakness in the arms or legs. 3  loss of motor control in the arms or legs. 4  general weakness and fatigue.5  tripping and falling. 6  dropping things.rogressive Symptoms of ALS. Regardless of the part of the body where ALS first makes an appearance, muscle weakness and atrophy eventually spread as the disease progresses. Later symptoms may include: 1  shortness of breath. 2  difficulty breathing. 3  difficulty swallowing. 4  difficulty chewing. 5  tight and stiff muscles.