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Motor neurons are nerve cells located in the brain, brainstem, and spinal cord that serve as controlling units and vital communication links between the nervous system and voluntary muscles of the body. Because ALS affects only motor neurons, the disease does not impair the mind, personality, intelligence or memory of the person. The parts of the body affected by early symptoms of ALS depend on which muscles in the body are damaged first.
For patients to be diagnosed with ALS, they must have signs and symptoms of damage to the upper and lower motor neurons that can not be attributed to other causes.
Difficulty swallowing and chewing hurts the ability of patients to eat normally and increase the risk of choking. This disease is included  into a group of diseases called motor neuron diseases, which are characterized by the gradual degeneration and death of motor neurons.
Messages from motor neurons brain (called upper motor neurons) are transmitted to motor neurons in the spinal cord (called lower motor neurons) and from there to each particular muscle.

Are affected eventually all muscles under voluntary control and patients lose their strength and ability to move his arms, legs and body. The first symptoms may include twitching, cramps or muscle stiffness, muscle weakness affecting an arm or leg, speech impaired or nose, or difficulty chewing or swallowing.
In some cases, symptoms initially affect one of the legs and patients have difficulty walking or running or realize that they face or stumble more often.
Although the sequence of emerging symptoms and the rate of disease progression vary from person to person, eventually patients will not stand or walk, lie down or get out of bed alone, or use his hands and arms. In ALS, motor neurons both upper and lower degenerate or die and stop sending messages to muscles.
When muscles of the diaphragm and chest wall fail, patients can’t breathe any more without a ventilator or breathing machine. Patients usually maintain control of eye muscles and functions of the bladder and intestines.

These widespread complaints then become more obvious weakness or atrophy, which can lead to the doctor suspecting ALS. At first, some patients see the effects of the disease in a hand or arm when they are hard to do simple tasks requiring manual dexterity such as buttoning a shirt, write or turn the key into a lock.
Because the disease usually does not affect cognitive abilities, patients realize their gradual loss of function, and can be anxiety or depression. Most people with ALS die from respiratory failure, usually between 3 to 5 years from the onset of ALS disease symptoms. Health professionals should explain the course of the disease and describe available treatments so that patients can make informed decisions in advance.

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