motor neurons degenerate, the can no longer send impulses to the muscle

fibers that normally result in muscle movement. Early symptoms of ALS often
include increasing muscle weakness, especially involving the arms and legs,
speech, swallowing or breathing. When muscles no longer receive the messages
from the motor neurons that they require to function, the muscles begin to
atrophy (become smaller). Limbs begin to look "thinner" as muscle tissue
atrophies.
ALS is a disease of the motor neurons, those nerve cells reaching from the brain
to the spinal cord (upper motor neurons) and the spinal cord to the peripheral
nerves (lower motor neurons) that control muscle movement. In ALS, for
unknown reasons, these neurons die, leading to a progressive loss of the ability
to move virtually any of the muscles in the body. ALS affects "voluntary"
muscles, those controlled by conscious thought, such as the arm, leg, and trunk
muscles. ALS, in and of itself, does not affect sensation, thought processes, the
heart muscle, or the "smooth" muscle of the digestive system, bladder, and
other internal organs. Most people with ALS retain function of their eye muscles
as well. However, various forms of ALS may be associated with a loss of
intellectual function (dementia ) or sensory symptoms.