Someone who previously walked normally may begin:
* Stumbling on flat surfaces
* Catching a foot on rugs or steps
* Losing balance more often
* Having trouble with routine walking
ALS is only one of many possible causes of frequent falls. Joint problems, medications, vision changes, inner-ear disorders, peripheral neuropathy, and other neurological conditions can cause similar symptoms. ([Mayo Clinic][1])
## 4. Muscle Twitching
Small involuntary muscle twitches, known as **fasciculations**, are commonly associated with ALS.
They may occur in areas such as the:
* Arms
* Shoulders
* Legs
* Tongue
However, muscle twitching is extremely common and can also happen because of exercise, stress, caffeine, sleep deprivation, or other benign causes.