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Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
As motor neurons degenerate, they can no longer send impulses to the muscle fibers that normally result in muscle movement. When muscles no longer receive the messages from the motor neurons that they require to function, the muscles begin to become smaller. Limbs begin to look "thinner" as muscle tissue gets smaller.
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