The earliest ALS symptoms are easy to overlook
Cramped, stiff muscles are one of the first subtle signs of ALS. Other early symptoms include muscle weakness in one arm or leg, twitching, slurred or nasal speech, and difficulty swallowing, depending on where the motor neuron damage first manifests in the body, according to the National Institute of Neurological Disorders and Stroke. There is no one test for an ALS diagnosis (it is based mainly on patients’ symptoms), but tests can be done to rule out other conditions. These may include electromyography (EMG), which records electrical activity in the muscles, and a nerve conduction study (NCS), which tests the nerves' ability to send a signal. Abnormalities in these test results may suggest damage to peripheral nerves or muscle disease rather than ALS.