The hallmark of PLS is progressive weakness and spasticity of voluntary muscles. The first symptoms are often tripping or difficulty lifting the legs. Other people may be the first to notice a change in the affected person’s gait. Occasionally, speaking (dysarthria) and swallowing (dysphagia) difficulties, or arm weakness are the first symptoms. Speech problems can begin with hoarseness, a reduced rate of speaking, excessive clearing of the throat, or slurred speech when a person is tired. In some cases, speech becomes so slurred that others cannot understand it. Drooling can be a problem as well due to weakened bulbar muscles.
Wherever symptoms originate, the legs, arms, hands, and speech and swallowing muscles will all eventually be affected. In time, assistive devices are needed, such as canes, walkers, or wheelchairs. Speech therapy and communication aids may become necessary as well. Many people report painful muscle spasms and other pain. Other common symptoms are hyperactive reflexes and Babinkski’s sign. Emotional lability is often reported as well.
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