How does als typically progress?

Linearly: Als is a relentlessly progressive neuromuscular disorder. The progression is steady and is not usually associated with remissions. The median survival is 3 - 5 years from diagnosis, although rare cases of survival 10 even 20 years are reported. Patients usually die of respiratory failure due to loss of diaphragm function.

ALS: Progressive weakness of muscles. Can progress from months to a few years.

Sequence: This nasty, incurable disorder may start with flickering muscles over hands and/or thighs. Next may experience muscle weakness, which later is associated with loss of bulk. Even later, swallowing, speaking and breathing can be afflicted. Terminal infections may end the disorder.