When Voluntary Movement Slowly Fades

ALS affects the nerve cells that control movement, gradually weakening muscles while sensation and awareness remain intact.
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Understanding a Motor Neuron Disease

Amyotrophic Lateral Sclerosis is a progressive neurodegenerative condition that damages upper and lower motor neurons, nerve cells responsible for voluntary muscle control. As these neurons deteriorate, the brain’s ability to send movement signals to muscles weakens, leading to increasing loss of strength and coordination. Importantly, ALS does not affect sensation, intelligence, or emotional awareness.
The Mind Remains Clear. The Signals Grow Quiet.
ALS disrupts motor pathways, not perception or cognition.

ALS, Simply Explained

Muscles move only when motor neurons carry signals from the brain and spinal cord. In ALS, these neurons slowly stop functioning. Muscles, no longer receiving instructions, weaken and shrink, not because they are damaged, but because communication has been lost. Over time, voluntary movement becomes increasingly difficult.

Symptoms

Symptoms vary by onset location and progression rate.
  • Early Motor Changes: Muscle weakness, clumsiness, foot drop, difficulty with fine motor tasks.
  • Muscle Twitching & Cramps: Visible fasciculations, stiffness, spasticity.
  • Speech & Swallowing Difficulties: Slurred speech, choking, changes in voice strength.
  • Respiratory Muscle Weakness: Shortness of breath, reduced breathing capacity.
  • Preserved Functions: Sensation, vision, bladder control, and cognitive clarity remain largely intact.

Assessments

A comprehensive evaluation to confirm diagnosis and monitor progression.
  • Neurological Examination: Upper and lower motor neuron signs.
  • Electrophysiological Testing: EMG and nerve conduction studies.
  • Neuroimaging Review: Excludes other structural causes.
  • Functional & Respiratory Assessment: Tracks mobility and breathing strength.
  • Multidisciplinary Review: Guides long-term planning and care.

Treatment

ALS management focuses on slowing progression, maintaining function, and preserving quality of life.
  • Neurorehabilitation: Maintains mobility, posture, and functional independence.
  • Speech & Swallow Therapy: Supports communication and safe nutrition.
  • Respiratory Support Planning: Monitors and assists breathing function.
  • Neuromodulation & Supportive Therapies: Optimises remaining neural efficiency.
  • Psychological & Caregiver Support: Addresses emotional and practical challenges.

Outcomes

ALS is a progressive condition, but timely intervention can significantly improve comfort, autonomy, communication, and dignity. A structured, anticipatory approach allows individuals and families to make informed decisions while maximising quality of life at every stage.

The Buddhi Clinic Advantage

Compassion-led care for complex motor neuron disorders
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Our interdisciplinary team integrates neurology, rehabilitation, communication therapy, respiratory planning, and psychosocial support, ensuring care that adapts as needs evolve.

Understanding ALS

Explore expert insights, practical guidance, and clear answers to your most pressing questions about ALS and its care.

ALS itself is not painful, though muscle cramps or stiffness may occur.
Most individuals retain full cognitive awareness.
Most cases are sporadic; a small percentage are genetic.
There is currently no cure, but treatments can slow progression and support function.
Progression varies widely between individuals.
Yes. Early, coordinated care makes a meaningful difference.