Seizures and rear limb weakness can be seen.

Eventually, additional muscles may become involved including those of the upper legs and arms (proximal limb weakness).

In respiratory onset ALS, this may occur before significant limb weakness is apparent.

Symptoms include rear limb weakness, decreased reflexes, muscle atrophy, megaesophagus, and loss of bark.

There is progressive limb weakness which is seen first in the hind legs.

If the ischaemia is intense or prolonged, limb weakness progresses to collapse.

If no pressure is felt, this is more likely organic limb weakness.

As a result, numbness, limb weakness, and blurred vision occur.

Dysphagia (difficulty swallowing) and proximal limb weakness develops later on in the disease.

People with hemiparesis often have difficulties maintaining their balance due to limb weaknesses leading to an inability to properly shift body weight.