Can other diseases be mistaken for ALS?

Howard E. Lewine, MD
Amyotrophic lateral sclerosis (ALS) is a disease of nerve cells that control muscle movement. In its severest form, it can totally paralyze a person, including the inability to breathe without assistance.

The symptoms of ALS can be similar to those of other neurological diseases. This is especially true early in the disease. Often the first symptom is hand weakness and difficulty with simple tasks such as buttoning a shirt. Or a person might have a hard time raising an arm above the head.

Other early symptoms could include leg weakness, falling or a foot drop. Some people first notice problems with speech or swallowing. Because ALS is a relatively rare disease, most often the above symptoms are due to some other medical problem.

The diagnosis of ALS is based upon the progressive pattern of the disease. There is no definitive diagnostic test. The history, neurological exam and nerve conduction testing usually is highly predictive. However, there must not be an alternative explanation for the symptoms and findings.

There are many medical conditions that can mimic the earliest symptoms of ALS. Even when symptoms progress, there will often be a need to exclude other diagnoses such as Lyme disease. Lyme disease can affect the brain, spinal cord or other nerves. Syphilis can also do this. These diseases can be excluded with simple blood tests.

Most recently, some experts suggest that head injuries might cause symptoms that look like ALS. In fact, there is some speculation that Lou Gehrig, the famous baseball player, did not have the disease that is named after him. It may have been an ALS-like syndrome from head injuries. He continued to play ball several times after head injury while he set a record of playing in 2,130 consecutive games. (Cal Ripken broke his record 15 years ago and went on to play in 2,632 consecutive games).
Harvard Medical School Viruses and Infectious Diseases: Protecting yourself from the invisible enemy

More About this Book

Harvard Medical School Viruses and Infectious Diseases: Protecting yourself from the invisible enemy

Have you ever wondered whether you are truly protected from infectious diseases ranging from the common cold to more deadly threats like rabies or bird flu? When you travel, are you protected from...

Continue Learning about Amyotrophic Lateral Sclerosis (ALS)

Know Your Risk: ALS in Hawaii
Know Your Risk: ALS in Hawaii
A few years ago, you may have been captivated by viral videos, Facebook callouts and images of local celebrities, like Jake Shimabukuro or Lee Ann Won...
Read More
What increases my risk for amyotrophic lateral sclerosis (ALS)?
Sigma NursingSigma Nursing
Amyotrophic lateral sclerosis (ALS) occurs most often in men between ages 40 and 70, with an average...
More Answers
How is amyotrophic lateral sclerosis (ALS) diagnosed?
Sigma NursingSigma Nursing
Differential diagnosis of amyotrophic lateral sclerosis (ALS) sometimes requires a variety of tests ...
More Answers
What should I discuss with my doctor if I have been diagnosed with ALS?
Univ. of Nev. School of Medicine, Family MedicineUniv. of Nev. School of Medicine, Family Medicine
If you have been diagnosed with amyotrophic lateral sclerosis (ALS) you should discuss with your doc...
More Answers

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.