Als what does it manifest?

Progressive weakness: Amyotrophic lateral sclerosis, als, or lou gehrig's disease is characterized by progressive weakness, muscle wasting, involuntary twitching (usually of many muscles), and difficulty speaking, swallowing, and breathing. The diagnosis can be supported (but not always confirmed) by electrodiagnostic testing (electromyography, or EMG and nerve conduction studies, or ncs).

Specifics: Amyotrophic lateral sclerosis is a disease of the motor nerve cell in brain and spinal cord, is progressive, irreversible, and causes muscle weakness, muscle flickering, and atrophy, in arms, legs, tongue, and leads to progressive disability, loss of ability to breathe and swallow. No cure, sole drug approved is Riluzole, which helps delay tracheostomy but not effect on weakness.