disease-modifying medications are available, including treatments targeted to specific genetic forms of ALS. For example, tofersen is approved for ALS associated with certain SOD1 mutations. ([NINDS][3])
## The Bottom Line
The earliest signs of Lou Gehrig’s disease often involve a **progressive loss of muscle function** rather than general pain or numbness.
Possible early symptoms include:
* Hand or arm weakness
* Foot or leg weakness
* Frequent tripping
* Muscle twitching
* Muscle cramps
* Slurred speech
* Difficulty swallowing
* Muscle wasting
* Stiffness
* Changes in emotional expression
These symptoms are **not specific to ALS**, and many are much more commonly caused by other conditions.
What deserves attention is a pattern of **persistent, progressive weakness or loss of muscle control**. If that happens, early neurological evaluation is important because a proper diagnosis requires examination and testing—not symptoms alone.
