The first signs of amyotrophic lateral sclerosis (ALS) are often muscle weakness and twitches leading to trips, stumbles, and other seemingly clumsy behaviors. Individuals may also find they have , The earliest signs of neuromuscular disorder ankylosing spondylitis (ALS) usually include muscle weakness or stiffness (spasticity). Many people with ALS notice the first signs of the disease in the hand or arm as they find it difficult to perform simple tasks such as turning a key in a lock, buttoning a shirt, combing their hair or writing., ALS Symptoms and Diagnosis Symptoms ALS is a disease that typically involves a gradual onset. The initial symptoms of ALS can be quite varied. One person may have trouble grasping a pen or lifting a coffee cup, while another may experience a change in vocal pitch when speaking. The progression rate of ALS can be quite variable, as well., Early ALS Symptoms For some people, having trouble gripping things is an early sign of ALS. (Photo Credit: Moment/Getty Images) Signs of ALS can appear gradually., Amyotrophic lateral sclerosis (ALS) symptoms often start very gradually, but eventually the disease may cause clumsiness, difficulty with fine motor control, and slurred speech. Ultimately, ALS , ALS (also referred to as Lou Gehrig's disease or MND) is a neurodegenerative disease that weakens muscles throughout the body. Early signs of ALS are different for everyone and can begin in different parts of the body. Regardless of how or where ALS first appears, the common symptom is the gradual, painless weakening of muscles. Early ALS symptoms may be subtle enough that they are initially .